NPI | 1447264379 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 204D00000X Neuromusculoskeletal Medicine & OMM (Licence: DE C2-0007135) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: DE C2-0007135) |
208000000X Pediatrics (Licence: DE C2-0007135) | |
Enumeration Date | 2006-07-28 |
Last Update Date | 2023-08-01 |