| NPI | 1518006451 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CA PT8117) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: CA DC24339) |
| Enumeration Date | 2007-02-06 |
| Last Update Date | 2009-04-21 |