| NPI | 1952452583 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: KY 38494) |
| Additional Taxonomies | 204D00000X Neuromusculoskeletal Medicine & OMM (Licence: KY 38494) |
| Enumeration Date | 2007-01-12 |
| Last Update Date | 2020-04-22 |