| NPI | 1467613158 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CO DR.0060986) |
| Additional Taxonomies | 204D00000X Neuromusculoskeletal Medicine & OMM (Licence: MI 5101017619) |
| 207Q00000X Family Medicine (Licence: MI 5101017619) | |
| Enumeration Date | 2008-06-24 |
| Last Update Date | 2019-05-02 |