| NPI | 1205926938 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CA PT 23700) |
| Additional Taxonomies | 2251E1200X Physical Therapist, Ergonomics (Licence: CA PT 23700) |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2007-07-09 |