| NPI | 1780682146 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 204D00000X Neuromusculoskeletal Medicine & OMM (Licence: OH 34.007613) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH 34007613s) |
| Enumeration Date | 2005-07-11 |
| Last Update Date | 2024-05-30 |