NPI | 1114921749 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: WV 938) |
Additional Taxonomies | 204D00000X Neuromusculoskeletal Medicine & OMM (Licence: WV 938) |
Enumeration Date | 2005-06-10 |
Last Update Date | 2007-08-02 |