NPI | 1841451424 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 225700000X Massage Therapist (Licence: AZ MT00834) |
Additional Taxonomies | 225700000X Massage Therapist (Licence: UT 6735789-4701) |
Enumeration Date | 2008-06-17 |
Last Update Date | 2014-02-18 |