NPI | 1003070723 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 204D00000X Neuromusculoskeletal Medicine & OMM (Licence: MI 5101017883) |
Additional Taxonomies | 208D00000X General Practice (Licence: MI 5101017883) |
Enumeration Date | 2008-07-11 |
Last Update Date | 2023-12-28 |