| NPI | 1659605574 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 226300000X Kinesiotherapist (Licence: CA ACE - T145486) |
| Additional Taxonomies | 133N00000X Nutritionist (Licence: CA ACE - T145486) |
| Enumeration Date | 2009-09-24 |
| Last Update Date | 2009-09-24 |