| NPI | 1144483397 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RS0010X Internal Medicine, Sports Medicine (Licence: TN 45486) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TN 45486) |
| Enumeration Date | 2008-07-08 |
| Last Update Date | 2017-11-14 |