| NPI | 1124387139 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NH EL07728) |
| Additional Taxonomies | 204D00000X Neuromusculoskeletal Medicine & OMM (Licence: NH EL07728) |
| 207Q00000X Family Medicine (Licence: AR E-10247) | |
| 204D00000X Neuromusculoskeletal Medicine & OMM (Licence: AR E-10247) | |
| Enumeration Date | 2012-05-10 |
| Last Update Date | 2021-10-20 |