| NPI | 1851390199 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NJ 25MB07847900) |
| Additional Taxonomies | 204D00000X Neuromusculoskeletal Medicine & OMM (Licence: NJ 25MB07847900) |
| Enumeration Date | 2005-07-19 |
| Last Update Date | 2013-06-13 |