NPI | 1861697948 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 204D00000X Neuromusculoskeletal Medicine & OMM (Licence: FL ME115003) |
Additional Taxonomies | 2084N0600X Psychiatry & Neurology, Clinical Neurophysiology (Licence: KY 40010) |
2084N0600X Psychiatry & Neurology, Clinical Neurophysiology (Licence: LA 203269) | |
Enumeration Date | 2007-06-18 |
Last Update Date | 2023-09-12 |