| NPI | 1801138839 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: CA 41412) |
| Additional Taxonomies | 174H00000X Health Educator (Licence: CA 41412) |
| Enumeration Date | 2013-03-15 |
| Last Update Date | 2013-03-15 |