| NPI | 1700908738 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 204D00000X Neuromusculoskeletal Medicine & OMM (Licence: OK 4443) |
| Additional Taxonomies | 204D00000X Neuromusculoskeletal Medicine & OMM (Licence: AZ 5015) |
| Enumeration Date | 2007-04-03 |
| Last Update Date | 2024-02-27 |