NPI | 1598740227 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 204D00000X Neuromusculoskeletal Medicine & OMM (Licence: MA 217255) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: MA 217255) |
Enumeration Date | 2005-12-15 |
Last Update Date | 2008-06-10 |