| NPI | 1821246307 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 224Y00000X Clinical Exercise Physiologist (Licence: CA 1039149) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: CA 31009) |
| Enumeration Date | 2008-09-08 |
| Last Update Date | 2017-04-10 |