NPI | 1134236292 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 204C00000X Neuromusculoskeletal Medicine, Sports Medicine (Licence: OR OR MD13345) |
Additional Taxonomies | 204C00000X Neuromusculoskeletal Medicine, Sports Medicine (Licence: WA MD00034626) |
Enumeration Date | 2006-08-24 |
Last Update Date | 2007-07-08 |