NPI | 1174930408 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX BP10048824) |
Additional Taxonomies | 204D00000X Neuromusculoskeletal Medicine & OMM (Licence: TX BP10048824) |
Enumeration Date | 2014-07-18 |
Last Update Date | 2014-07-18 |