NPI | 1770679987 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 204D00000X Neuromusculoskeletal Medicine & OMM (Licence: IA 02045) |
Additional Taxonomies | 204D00000X Neuromusculoskeletal Medicine & OMM (Licence: OR 16402) |
Enumeration Date | 2006-10-05 |
Last Update Date | 2007-07-08 |