| NPI | 1992025019 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: GA MT005325) |
| Additional Taxonomies | 173C00000X Reflexologist (Licence: GA MT005325) |
| Enumeration Date | 2010-06-11 |
| Last Update Date | 2010-06-11 |