NPI | 1245745579 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 204C00000X Neuromusculoskeletal Medicine, Sports Medicine (Licence: CA A180285) |
Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CA A180285) |
Enumeration Date | 2017-12-08 |
Last Update Date | 2023-12-04 |