| NPI | 1619317658 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251X0800X Physical Therapist, Orthopedic (Licence: CA PT17853) |
| Additional Taxonomies | 2251E1200X Physical Therapist, Ergonomics (Licence: CA PT17853) |
| 225100000X Physical Therapist (Licence: CA PT17853) | |
| 2251N0400X Physical Therapist, Neurology (Licence: CA PT17853) | |
| Enumeration Date | 2013-07-03 |
| Last Update Date | 2015-07-29 |