NPI | 1043396047 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 237675) |
Additional Taxonomies | 204D00000X Neuromusculoskeletal Medicine & OMM (Licence: NY 237675) |
Enumeration Date | 2006-10-31 |
Last Update Date | 2022-08-03 |