| NPI | 1992083802 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 204D00000X Neuromusculoskeletal Medicine & OMM (Licence: TN 4078) |
| Additional Taxonomies | 204D00000X Neuromusculoskeletal Medicine & OMM (Licence: OH 34005898) |
| 204D00000X Neuromusculoskeletal Medicine & OMM (Licence: IN 02003944A) | |
| Enumeration Date | 2011-07-26 |
| Last Update Date | 2021-12-08 |