| NPI | 1205932910 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MD D54153) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0101059209) |
| 207Q00000X Family Medicine (Licence: AZ 7879) | |
| 207Q00000X Family Medicine (Licence: MA 49336) | |
| 207Q00000X Family Medicine (Licence: NH 14325) | |
| 207QA0505X Family Medicine, Adult Medicine (Licence: VA 0101059209) | |
| 208VP0000X Pain Medicine, Pain Medicine (Licence: VA 0101059209) | |
| 208VP0000X Pain Medicine, Pain Medicine (Licence: MD D54153) | |
| 171100000X Acupuncturist (Licence: VA 0101059209) | |
| 171100000X Acupuncturist (Licence: MD D54153) | |
| 204D00000X Neuromusculoskeletal Medicine & OMM (Licence: VA 0101059209) | |
| 204D00000X Neuromusculoskeletal Medicine & OMM (Licence: MD D541153) | |
| 204D00000X Neuromusculoskeletal Medicine & OMM (Licence: MA 49336) | |
| 204D00000X Neuromusculoskeletal Medicine & OMM (Licence: NH 14325) | |
| Enumeration Date | 2006-09-16 |
| Last Update Date | 2020-08-18 |