NPI | 1962835603 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225700000X Massage Therapist (Licence: DC MT1511) |
Additional Taxonomies | 225700000X Massage Therapist (Licence: VA 0019010788) |
Enumeration Date | 2013-08-16 |
Last Update Date | 2013-08-16 |