| NPI | 1306367230 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PS0010X Emergency Medicine, Sports Medicine (Licence: MI 4301119280) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 4301119280) |
| Enumeration Date | 2017-06-30 |
| Last Update Date | 2023-10-20 |