| NPI | 1093058406 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 204D00000X Neuromusculoskeletal Medicine & OMM (Licence: PA OS018778) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PA OS018778) |
| Enumeration Date | 2013-04-03 |
| Last Update Date | 2023-11-06 |