| NPI | 1922101435 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CA 7071) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: CA DC 0122380) |
| Enumeration Date | 2006-09-07 |
| Last Update Date | 2025-09-11 |