| NPI | 1629231402 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 226300000X Kinesiotherapist (Licence: IL 1560) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: TX MT026908) |
| Enumeration Date | 2008-07-02 |
| Last Update Date | 2008-07-02 |