| NPI | 1013925544 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CA PT13737) |
| Additional Taxonomies | 2251E1200X Physical Therapist, Ergonomics (Licence: CA PT13737) |
| 2251X0800X Physical Therapist, Orthopedic (Licence: CA PT13737) | |
| Enumeration Date | 2006-08-03 |
| Last Update Date | 2012-03-15 |