| NPI | 1184815730 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2083A0300X Preventive Medicine Addiction Medicine (Licence: ME DO1967) |
| Additional Taxonomies | 204D00000X Neuromusculoskeletal Medicine & OMM (Licence: ME 1967) |
| Enumeration Date | 2007-08-08 |
| Last Update Date | 2022-09-23 |