| NPI | 1881737310 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: WA MA00023488) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: WA 60455183) |
| Enumeration Date | 2007-02-15 |
| Last Update Date | 2024-07-31 |