| NPI | 1437378049 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CA 304209) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: CA DC28583) |
| Enumeration Date | 2007-04-24 |
| Last Update Date | 2023-06-14 |