| NPI | 1841555984 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MN 63859) |
| Additional Taxonomies | 204D00000X Neuromusculoskeletal Medicine & OMM (Licence: MN 63859) |
| Enumeration Date | 2012-07-04 |
| Last Update Date | 2020-09-18 |