| NPI | 1144333428 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: ME 2255) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MA 239417) |
| 204D00000X Neuromusculoskeletal Medicine & OMM (Licence: ME 2255) | |
| Enumeration Date | 2006-08-17 |
| Last Update Date | 2011-10-28 |