| NPI | 1295046928 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TN 2715) |
| Additional Taxonomies | 204D00000X Neuromusculoskeletal Medicine & OMM (Licence: MI 5101018783) |
| 207Q00000X Family Medicine (Licence: MI 5101018783) | |
| 204D00000X Neuromusculoskeletal Medicine & OMM (Licence: TN 2715) | |
| Enumeration Date | 2010-06-28 |
| Last Update Date | 2015-04-24 |