| NPI | 1013907427 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 204D00000X Neuromusculoskeletal Medicine & OMM (Licence: MI 5101027552) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX R7399) |
| Enumeration Date | 2005-10-26 |
| Last Update Date | 2023-08-10 |