| NPI | 1174857262 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: IL 056012069) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: IL 2057193) |
| Enumeration Date | 2009-09-23 |
| Last Update Date | 2019-08-08 |