NPI | 1518954197 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 204D00000X Neuromusculoskeletal Medicine & OMM (Licence: MO 2003004986) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: MO 2003004986) |
Enumeration Date | 2005-09-29 |
Last Update Date | 2024-10-17 |