| NPI | 1801049465 |
|---|---|
| Former Name | VERONICA FUMIE DUNLAP |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: OR 14459) |
| Additional Taxonomies | 171W00000X Contractor (Licence: OR 14459) |
| Enumeration Date | 2008-10-28 |
| Last Update Date | 2015-10-01 |