| NPI | 1922837681 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: NC 19362) |
| Additional Taxonomies | 171400000X Health & Wellness Coach |
| Enumeration Date | 2024-07-31 |
| Last Update Date | 2026-02-07 |