NPI | 1093795478 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX N8122) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: NJ MB06631300) |
204D00000X Neuromusculoskeletal Medicine & OMM (Licence: NJ MB06631300) | |
204D00000X Neuromusculoskeletal Medicine & OMM (Licence: TX N8122) | |
Enumeration Date | 2006-01-20 |
Last Update Date | 2011-09-19 |