| NPI | 1144291089 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PS0010X Emergency Medicine, Sports Medicine (Licence: MO 2000161049) |
| Additional Taxonomies | 207PS0010X Emergency Medicine, Sports Medicine (Licence: IN 01088509A) |
| 207PS0010X Emergency Medicine, Sports Medicine (Licence: AR E-11385) | |
| 207PS0010X Emergency Medicine, Sports Medicine (Licence: FL ME124514) | |
| Enumeration Date | 2006-01-30 |
| Last Update Date | 2022-10-06 |