| NPI | 1144210717 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: LA 13814R) |
| Additional Taxonomies | 204D00000X Neuromusculoskeletal Medicine & OMM (Licence: LA 13814R) |
| Enumeration Date | 2005-10-25 |
| Last Update Date | 2017-09-05 |