| NPI | 1902343908 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 173C00000X Reflexologist |
| Additional Taxonomies | 101Y00000X Counselor |
| 171M00000X Case Manager/Care Coordinator | |
| 225700000X Massage Therapist | |
| Enumeration Date | 2017-01-27 |
| Last Update Date | 2020-01-09 |