NPI | 1063609535 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 204D00000X Neuromusculoskeletal Medicine & OMM (Licence: CO 41940) |
Additional Taxonomies | 204D00000X Neuromusculoskeletal Medicine & OMM (Licence: CA G16329) |
Enumeration Date | 2007-09-28 |
Last Update Date | 2025-02-02 |