| NPI | 1619060985 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IL 070-007373) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: IL 198.000441) |
| 175F00000X Naturopath | |
| Enumeration Date | 2006-10-01 |
| Last Update Date | 2016-05-24 |