| NPI | 1801160056 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: NM 7121) |
| Additional Taxonomies | 101YP1600X Counselor, Pastoral |
| 175L00000X Homeopath | |
| Enumeration Date | 2012-03-06 |
| Last Update Date | 2013-07-31 |