| NPI | 1699781831 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX N3592) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CT 000503) |
| 204D00000X Neuromusculoskeletal Medicine & OMM (Licence: TX N3592) | |
| Enumeration Date | 2006-07-31 |
| Last Update Date | 2011-07-22 |