| NPI | 1477511939 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OH 34-00-7547-S) |
| Additional Taxonomies | 204D00000X Neuromusculoskeletal Medicine & OMM (Licence: OH 34-00-7547-S) |
| Enumeration Date | 2006-05-03 |
| Last Update Date | 2008-01-18 |