| NPI | 1902280753 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: IL 160006699) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: IL 227012498) |
| Enumeration Date | 2015-07-10 |
| Last Update Date | 2015-07-10 |