| NPI | 1265515977 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 204D00000X Neuromusculoskeletal Medicine & OMM (Licence: MI 4301042058) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology Neurology (Licence: MI 4301042058) |
| Enumeration Date | 2006-10-24 |
| Last Update Date | 2015-06-19 |