| NPI | 1194368779 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: IL 198001498) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: IL 227016825) |
| Enumeration Date | 2019-10-25 |
| Last Update Date | 2019-10-25 |