| NPI | 1851832638 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 172M00000X Mechanotherapist (Licence: RI MT02104) |
| Additional Taxonomies | 173C00000X Reflexologist (Licence: RI MT02104) |
| Enumeration Date | 2017-03-14 |
| Last Update Date | 2017-03-14 |