| NPI | 1538348792 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CT 005244) |
| Additional Taxonomies | 175F00000X Naturopath (Licence: CT 000417) |
| Enumeration Date | 2007-10-24 |
| Last Update Date | 2012-02-10 |