| NPI | 1104120195 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: CA A159006) |
| Additional Taxonomies | 175F00000X Naturopath (Licence: CA 608) |
| Enumeration Date | 2011-01-05 |
| Last Update Date | 2021-09-15 |