| NPI | 1831537109 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 204D00000X Neuromusculoskeletal Medicine & OMM (Licence: ME DO2620) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: ME TP13121) |
| Enumeration Date | 2013-06-10 |
| Last Update Date | 2022-07-21 |