| NPI | 1710067681 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 175F00000X Naturopath (Licence: AZ 16-1548) |
| Additional Taxonomies | 175F00000X Naturopath (Licence: KS 21-00039) |
| 225100000X Physical Therapist (Licence: KS 11-00596) | |
| 225100000X Physical Therapist (Licence: AZ 8414) | |
| 2251H1200X Physical Therapist, Hand (Licence: CA 9310000379) | |
| Enumeration Date | 2006-10-16 |
| Last Update Date | 2019-05-10 |