| NPI | 1730523796 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 204D00000X Neuromusculoskeletal Medicine & OMM (Licence: ME DO2518) |
| Additional Taxonomies | 204D00000X Neuromusculoskeletal Medicine & OMM (Licence: CA 20A15667) |
| 207Q00000X Family Medicine (Licence: ME DO2518) | |
| Enumeration Date | 2013-04-22 |
| Last Update Date | 2022-07-21 |