| NPI | 1093882102 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine (Licence: ME 1094) |
| Additional Taxonomies | 204D00000X Neuromusculoskeletal Medicine & OMM (Licence: ME 1094) |
| Enumeration Date | 2006-11-30 |
| Last Update Date | 2007-09-19 |