NPI | 1780925107 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225700000X Massage Therapist (Licence: OR 14735) |
Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: OR 201390797) |
Enumeration Date | 2013-03-11 |
Last Update Date | 2018-01-17 |