| NPI | 1891827101 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: OR PT1994) |
| Additional Taxonomies | 175F00000X Naturopath (Licence: OR ND1096) |
| Enumeration Date | 2007-03-12 |
| Last Update Date | 2008-07-08 |