| NPI | 1457741316 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2251X0800X Physical Therapist, Orthopedic (Licence: CA PT24232) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CA PT24232) |
| 2251E1200X Physical Therapist, Ergonomics (Licence: CA PT24232) | |
| Enumeration Date | 2015-01-30 |
| Last Update Date | 2015-01-30 |