| NPI | 1265431415 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: TX E8757) |
| Additional Taxonomies | 204D00000X Neuromusculoskeletal Medicine & OMM (Licence: TX E8757) |
| Enumeration Date | 2005-07-19 |
| Last Update Date | 2016-10-19 |