NPI | 1952712358 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225700000X Massage Therapist (Licence: TX MT132983) |
Additional Taxonomies | 171100000X Acupuncturist |
246RP1900X Technician, Pathology, Phlebotomy | |
Enumeration Date | 2014-05-19 |
Last Update Date | 2021-08-02 |