| NPI | 1417927120 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA 20A20498) |
| Additional Taxonomies | 204D00000X Neuromusculoskeletal Medicine & OMM (Licence: AZ 4298) |
| 207Q00000X Family Medicine (Licence: AZ 4298) | |
| Enumeration Date | 2006-01-25 |
| Last Update Date | 2023-01-16 |