| 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 |