| NPI | 1093918633 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 175F00000X Naturopath (Licence: DC 2622) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MD 6692) |
| 225100000X Physical Therapist (Licence: DC 2622) | |
| Enumeration Date | 2007-06-11 |
| Last Update Date | 2007-07-08 |