| NPI | 1235392382 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 204D00000X Neuromusculoskeletal Medicine & OMM (Licence: CA 20A12654) |
| Additional Taxonomies | 204D00000X Neuromusculoskeletal Medicine & OMM (Licence: NY 262860) |
| Enumeration Date | 2008-07-09 |
| Last Update Date | 2021-07-30 |