NPI | 1548256308 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 204D00000X Neuromusculoskeletal Medicine & OMM (Licence: MA 60481) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 60481) |
Enumeration Date | 2005-09-26 |
Last Update Date | 2016-11-14 |