| 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 |