| NPI | 1578706743 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CA PT12930) |
| Additional Taxonomies | 2251E1200X Physical Therapist, Ergonomics (Licence: CA PT12930) |
| Enumeration Date | 2009-04-16 |
| Last Update Date | 2009-04-16 |