| NPI | 1295982700 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PS0010X Emergency Medicine, Sports Medicine (Licence: CO DR.0057432) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL os11396) |
| 207PS0010X Emergency Medicine, Sports Medicine (Licence: SC 1422) | |
| Enumeration Date | 2008-08-26 |
| Last Update Date | 2023-02-28 |