NPI | 1376674341 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 204D00000X Neuromusculoskeletal Medicine & OMM (Licence: CA 20A6532) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA 20A6532) |
Enumeration Date | 2007-03-08 |
Last Update Date | 2013-04-03 |