| NPI | 1053494831 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: LA 11473) |
| Additional Taxonomies | 204D00000X Neuromusculoskeletal Medicine & OMM (Licence: MS 11473) |
| 2084N0400X Psychiatry & Neurology Neurology (Licence: MS 11473) | |
| Enumeration Date | 2006-10-23 |
| Last Update Date | 2020-12-23 |