| NPI | 1770385379 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: HI MAT-15682) |
| Additional Taxonomies | 163WP0000X Registered Nurse, Pain Management (Licence: HI RN-68669) |
| Enumeration Date | 2025-03-25 |
| Last Update Date | 2025-03-25 |