| NPI | 1649339995 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CA 27315) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: CA AC 15285) |
| Enumeration Date | 2006-12-06 |
| Last Update Date | 2013-10-27 |