| NPI | 1891724688 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MI 5101014038) |
| Additional Taxonomies | 204D00000X Neuromusculoskeletal Medicine & OMM (Licence: MI 5101014038) |
| Enumeration Date | 2006-07-02 |
| Last Update Date | 2021-03-31 |