NPI | 1841488228 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 172M00000X Mechanotherapist (Licence: OR 4667) |
Additional Taxonomies | 133N00000X Nutritionist (Licence: CO 000639) |
Enumeration Date | 2007-10-10 |
Last Update Date | 2007-10-10 |