| NPI | 1568986446 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 204D00000X Neuromusculoskeletal Medicine & OMM (Licence: AZ 55565) |
| Additional Taxonomies | 2251X0800X Physical Therapist Orthopedic |
| 2471S1302X Radiologic Technologist Sonography | |
| 133NN1002X Nutritionist Nutrition, Education | |
| 173F00000X Sleep Specialist, PhD | |
| 202D00000X (Licence: AZ 13174) | |
| 225100000X Physical Therapist (Licence: AZ 13174) | |
| Enumeration Date | 2017-08-01 |
| Last Update Date | 2022-08-26 |