| NPI | 1740244193 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA OP60640808) |
| Additional Taxonomies | 204D00000X Neuromusculoskeletal Medicine & OMM (Licence: MI 5101010625) |
| 207Q00000X Family Medicine (Licence: MI 5101010625) | |
| 204D00000X Neuromusculoskeletal Medicine & OMM (Licence: WA OP60640808) | |
| Enumeration Date | 2006-04-13 |
| Last Update Date | 2016-06-07 |