| NPI | 1679675235 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 204D00000X Neuromusculoskeletal Medicine & OMM (Licence: NH 8555) |
| Additional Taxonomies | 204D00000X Neuromusculoskeletal Medicine & OMM (Licence: CA 20A13504) |
| 207Q00000X Family Medicine (Licence: NH 8555) | |
| 207Q00000X Family Medicine (Licence: CA 20A13504) | |
| Enumeration Date | 2006-09-03 |
| Last Update Date | 2016-08-02 |