NPI | 1922057363 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 204D00000X Neuromusculoskeletal Medicine & OMM (Licence: PA OS014076) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA OS014076) |
Enumeration Date | 2006-05-10 |
Last Update Date | 2023-02-21 |