| NPI | 1740272400 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 204D00000X Neuromusculoskeletal Medicine & OMM (Licence: FL OS9892) |
| Additional Taxonomies | 204D00000X Neuromusculoskeletal Medicine & OMM (Licence: IA 02365) |
| Enumeration Date | 2005-08-18 |
| Last Update Date | 2007-07-08 |