| NPI | 1487811329 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL OS20618) |
| Additional Taxonomies | 204D00000X Neuromusculoskeletal Medicine & OMM (Licence: FL OS20618) |
| 207Q00000X Family Medicine (Licence: MA 262156) | |
| Enumeration Date | 2008-05-19 |
| Last Update Date | 2024-09-06 |