| NPI | 1780975854 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: FL Ma52337) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: FL ma61381) |
| Enumeration Date | 2011-04-25 |
| Last Update Date | 2011-04-25 |