| NPI | 1346537370 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RS0010X Internal Medicine Sports Medicine (Licence: CO DR.0069417) |
| Additional Taxonomies | 207RS0010X Internal Medicine Sports Medicine (Licence: TN 4058) |
| 207RS0010X Internal Medicine Sports Medicine (Licence: IL 036.139147) | |
| Enumeration Date | 2011-06-28 |
| Last Update Date | 2023-04-17 |