| NPI | 1902635220 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: IN MT22408438) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: IL 227023654) |
| Enumeration Date | 2024-07-26 |
| Last Update Date | 2025-11-14 |