| NPI | 1346338563 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 204D00000X Neuromusculoskeletal Medicine & OMM (Licence: OR MD09471) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: OR MD09471) |
| Enumeration Date | 2006-10-11 |
| Last Update Date | 2007-07-08 |