| NPI | 1821352915 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IL 070013559) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: IL 198001289) |
| Enumeration Date | 2012-07-03 |
| Last Update Date | 2023-10-30 |