| NPI | 1225039902 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 204D00000X Neuromusculoskeletal Medicine & OMM (Licence: PA OS0501240) |
| Additional Taxonomies | 204D00000X Neuromusculoskeletal Medicine & OMM (Licence: IN 02004171A) |
| Enumeration Date | 2005-08-03 |
| Last Update Date | 2015-04-14 |