| NPI | 1447367685 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 204D00000X Neuromusculoskeletal Medicine & OMM (Licence: NY 234144) |
| Additional Taxonomies | 204D00000X Neuromusculoskeletal Medicine & OMM (Licence: WV 2182) |
| Enumeration Date | 2006-08-24 |
| Last Update Date | 2011-06-21 |