| NPI | 1063657419 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 226300000X Kinesiotherapist (Licence: CA 97-07-11-003) |
| Additional Taxonomies | 225XN1300X Occupational Therapist Neurorehabilitation (Licence: CA 97-07-11-003) |
| Enumeration Date | 2008-12-12 |
| Last Update Date | 2008-12-12 |