| NPI | 1326783325 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CA 306879) |
| Additional Taxonomies | 171400000X Health & Wellness Coach |
| Enumeration Date | 2022-05-03 |
| Last Update Date | 2024-09-12 |