| NPI | 1710004627 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225X00000X Occupational Therapist |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: IL 160003627) |
| Enumeration Date | 2007-03-24 |
| Last Update Date | 2021-10-14 |