| NPI | 1710096581 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1170939) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CA PT26493) |
| 2251E1200X Physical Therapist Ergonomics (Licence: CA PT26493) | |
| 2251G0304X Physical Therapist Geriatrics (Licence: CA PT26493) | |
| 2251H1200X Physical Therapist Hand (Licence: CA PT26493) | |
| 2251N0400X Physical Therapist Neurology (Licence: CA PT26493) | |
| 2251P0200X Physical Therapist Pediatrics (Licence: CA PT26493) | |
| 2251S0007X Physical Therapist Sports (Licence: CA PT26493) | |
| 2251X0800X Physical Therapist Orthopedic (Licence: CA PT26493) | |
| Enumeration Date | 2006-08-29 |
| Last Update Date | 2009-12-21 |