| NPI | 1578548749 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251X0800X Physical Therapist Orthopedic (Licence: CA PT17997) |
| Additional Taxonomies | 2251E1200X Physical Therapist Ergonomics (Licence: CA PT17997) |
| 2251G0304X Physical Therapist Geriatrics (Licence: CA PT17997) | |
| Enumeration Date | 2005-12-10 |
| Last Update Date | 2019-12-20 |