NPI | 1093082869 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 204D00000X Neuromusculoskeletal Medicine & OMM (Licence: CT 052918) |
Additional Taxonomies | 204D00000X Neuromusculoskeletal Medicine & OMM (Licence: NY 275366) |
Enumeration Date | 2011-11-22 |
Last Update Date | 2015-09-01 |