NPI | 1982195327 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 225700000X Massage Therapist (Licence: LA 8782) |
Additional Taxonomies | 225700000X Massage Therapist (Licence: NH 4052) |
Enumeration Date | 2018-05-22 |
Last Update Date | 2018-05-22 |