| NPI | 1144285156 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174400000X Specialist (Licence: AL 8637) |
| Additional Taxonomies | 204C00000X Neuromusculoskeletal Medicine, Sports Medicine (Licence: AL 00008631) |
| Enumeration Date | 2006-04-20 |
| Last Update Date | 2024-05-22 |