| NPI | 1952462699 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: CA EN 36) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CA 16695) |
| Enumeration Date | 2006-12-13 |
| Last Update Date | 2007-07-08 |