| NPI | 1962440099 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 204D00000X Neuromusculoskeletal Medicine & OMM (Licence: AZ 1780) |
| Additional Taxonomies | 204D00000X Neuromusculoskeletal Medicine & OMM (Licence: MO 111911) |
| 204D00000X Neuromusculoskeletal Medicine & OMM (Licence: IN 02000898A) | |
| Enumeration Date | 2006-06-02 |
| Last Update Date | 2022-09-25 |