| NPI | 1952297400 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: FL MA74056) |
| Additional Taxonomies | 225A00000X Music Therapist (Licence: FL MA74056) |
| Enumeration Date | 2025-06-12 |
| Last Update Date | 2025-06-17 |