| NPI | 1831359728 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IL 070011060) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: IL 227003120) |
| Enumeration Date | 2008-06-13 |
| Last Update Date | 2008-06-13 |