| NPI | 1265441430 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 204D00000X Neuromusculoskeletal Medicine & OMM (Licence: WY 3675A) |
| Additional Taxonomies | 207KA0200X Allergy & Immunology, Allergy (Licence: WY 3675A) |
| 207Q00000X Family Medicine (Licence: WY 3675A) | |
| 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: WY 3575A) | |
| 2083P0500X Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine (Licence: WY 3675A) | |
| Enumeration Date | 2006-08-06 |
| Last Update Date | 2007-07-08 |