| NPI | 1437430386 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 172M00000X Mechanotherapist (Licence: CA CAMTC 20733) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: OR LMT-24958) |
| Enumeration Date | 2011-09-06 |
| Last Update Date | 2020-03-03 |