| NPI | 1851375083 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CA PT6020) |
| Additional Taxonomies | 2251C2600X Physical Therapist, Cardiopulmonary (Licence: CA PT 6020) |
| Enumeration Date | 2005-12-01 |
| Last Update Date | 2009-10-07 |