NPI | 1689750853 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 204D00000X Neuromusculoskeletal Medicine & OMM (Licence: FL OS16262) |
Additional Taxonomies | 204D00000X Neuromusculoskeletal Medicine & OMM (Licence: ME 1555) |
Enumeration Date | 2006-10-31 |
Last Update Date | 2020-01-20 |