| NPI | 1306997861 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 204D00000X Neuromusculoskeletal Medicine & OMM (Licence: GA 59043) |
| Additional Taxonomies | 204D00000X Neuromusculoskeletal Medicine & OMM (Licence: VA 0102201293) |
| 204D00000X Neuromusculoskeletal Medicine & OMM (Licence: DE C2-0006618) | |
| 2083X0100X Preventive Medicine, Occupational Medicine (Licence: GA 59043) | |
| Enumeration Date | 2007-01-12 |
| Last Update Date | 2021-09-22 |