| NPI | 1134411168 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 204D00000X Neuromusculoskeletal Medicine & OMM (Licence: TX V2236) |
| Additional Taxonomies | 204D00000X Neuromusculoskeletal Medicine & OMM (Licence: CT 049238) |
| Enumeration Date | 2011-05-10 |
| Last Update Date | 2024-12-03 |