| NPI | 1144363417 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: IL 160001087) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: IL 227005123) |
| Enumeration Date | 2007-02-15 |
| Last Update Date | 2007-07-08 |