| NPI | 1881922748 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: ME A-1823-14) |
| Additional Taxonomies | 204D00000X Neuromusculoskeletal Medicine & OMM (Licence: NM A-1823-14) |
| Enumeration Date | 2009-12-03 |
| Last Update Date | 2024-05-29 |