| NPI | 1629464060 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 204D00000X Neuromusculoskeletal Medicine & OMM (Licence: NC 2020-00403) |
| Additional Taxonomies | 204D00000X Neuromusculoskeletal Medicine & OMM (Licence: FL OS15697) |
| Enumeration Date | 2015-04-13 |
| Last Update Date | 2025-02-03 |