| NPI | 1861160392 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: IN MT21706364) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: KY 262134) |
| Enumeration Date | 2021-08-31 |
| Last Update Date | 2021-08-31 |