NPI | 1437189305 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: MO 2010023062) |
Additional Taxonomies | 204D00000X Neuromusculoskeletal Medicine & OMM (Licence: AZ 3489) |
Enumeration Date | 2006-07-04 |
Last Update Date | 2015-06-12 |