| NPI | 1548400179 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 224Z00000X Occupational Therapy Assistant (Licence: IL 057.001111) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: IL 227.009599) |
| Enumeration Date | 2009-02-22 |
| Last Update Date | 2018-03-02 |