| NPI | 1346278694 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 204D00000X Neuromusculoskeletal Medicine & OMM (Licence: MI 5101-009715) |
| Additional Taxonomies | 204D00000X Neuromusculoskeletal Medicine & OMM (Licence: MI 009715) |
| 207Q00000X Family Medicine (Licence: MI 009715) | |
| Enumeration Date | 2006-06-28 |
| Last Update Date | 2023-07-10 |