| NPI | 1346253580 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MO 2000165578) |
| Additional Taxonomies | 204D00000X Neuromusculoskeletal Medicine & OMM (Licence: MO 2000165578) |
| Enumeration Date | 2006-08-15 |
| Last Update Date | 2023-03-14 |