NPI | 1245237858 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 204D00000X Neuromusculoskeletal Medicine & OMM (Licence: MO R1J92) |
Additional Taxonomies | 208D00000X General Practice (Licence: MO R1J92) |
Enumeration Date | 2005-06-29 |
Last Update Date | 2019-09-23 |