| NPI | 1821481292 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 204D00000X Neuromusculoskeletal Medicine & OMM (Licence: OH 34.012669CTR) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 34.012669CTR) |
| Enumeration Date | 2015-03-10 |
| Last Update Date | 2022-08-22 |