NPI | 1801344577 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225700000X Massage Therapist (Licence: AK 130033) |
Additional Taxonomies | 225700000X Massage Therapist (Licence: TX MT123921) |
225700000X Massage Therapist (Licence: CO MT.0015832) | |
Enumeration Date | 2016-09-12 |
Last Update Date | 2020-04-10 |