| NPI | 1275829939 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX R7574) |
| Additional Taxonomies | 204D00000X Neuromusculoskeletal Medicine & OMM (Licence: NJ 25MB09366700) |
| 207Q00000X Family Medicine (Licence: NJ 25MB09366700) | |
| Enumeration Date | 2011-06-21 |
| Last Update Date | 2024-03-14 |