| NPI | 1952368318 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 204D00000X Neuromusculoskeletal Medicine & OMM (Licence: OR do22877) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: OR DO22877) |
| Enumeration Date | 2006-04-28 |
| Last Update Date | 2023-12-29 |