| NPI | 1073750014 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0600X Psychiatry & Neurology Clinical Neurophysiology (Licence: CA A100375) |
| Additional Taxonomies | 204D00000X Neuromusculoskeletal Medicine & OMM (Licence: CA A100375) |
| Enumeration Date | 2009-01-13 |
| Last Update Date | 2014-01-08 |