| NPI | 1316055999 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NY 188071) |
| Additional Taxonomies | 204D00000X Neuromusculoskeletal Medicine & OMM (Licence: CT 053785) |
| 204D00000X Neuromusculoskeletal Medicine & OMM (Licence: FL ME124820) | |
| Enumeration Date | 2006-08-25 |
| Last Update Date | 2024-04-22 |