| NPI | 1073577581 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 192191) |
| Additional Taxonomies | 204C00000X Neuromusculoskeletal Medicine, Sports Medicine (Licence: NY 192191) |
| 204D00000X Neuromusculoskeletal Medicine & OMM (Licence: NY 192191) | |
| Enumeration Date | 2006-04-12 |
| Last Update Date | 2019-04-02 |