| NPI | 1891936985 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: CA SAN DIEGO HHP 0054) |
| Additional Taxonomies | 173C00000X Reflexologist (Licence: CA SAN DIEGO HHP 0054) |
| Enumeration Date | 2009-03-19 |
| Last Update Date | 2009-03-19 |