| NPI | 1801645130 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: IL 198001676) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: IL 227.014192) |
| Enumeration Date | 2024-05-17 |
| Last Update Date | 2024-12-11 |