NPI | 1730899444 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 225700000X Massage Therapist (Licence: WV 2017-3502) |
Additional Taxonomies | 225700000X Massage Therapist (Licence: MD M06141) |
225700000X Massage Therapist (Licence: VA 0019016915) | |
Enumeration Date | 2022-12-05 |
Last Update Date | 2022-12-05 |