NPI | 1679709893 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX N7881) |
Additional Taxonomies | 204D00000X Neuromusculoskeletal Medicine & OMM (Licence: TX N7881) |
Enumeration Date | 2009-06-02 |
Last Update Date | 2012-06-25 |