NPI | 1639436330 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 204D00000X Neuromusculoskeletal Medicine & OMM (Licence: MO 2010019783) |
Additional Taxonomies | 204D00000X Neuromusculoskeletal Medicine & OMM (Licence: IL 036.130265) |
Enumeration Date | 2012-04-19 |
Last Update Date | 2021-06-29 |