| NPI | 1700298478 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225400000X Rehabilitation Practitioner |
| Additional Taxonomies | 225400000X Rehabilitation Practitioner (Licence: CA E2294060) |
| Enumeration Date | 2014-05-28 |
| Last Update Date | 2014-05-28 |