| NPI | 1831391234 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 226300000X Kinesiotherapist (Licence: IL 1290) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: IL 227-001883) |
| Enumeration Date | 2007-06-05 |
| Last Update Date | 2025-09-11 |