| NPI | 1487700050 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CA PT 16382) |
| Additional Taxonomies | 2251E1300X Physical Therapist, Electrophysiology, Clinical (Licence: CA EN51) |
| Enumeration Date | 2007-01-26 |
| Last Update Date | 2011-02-04 |