| NPI | 1407054380 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PS0010X Emergency Medicine Sports Medicine (Licence: MA 277910) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MA 277910) |
| Enumeration Date | 2007-07-03 |
| Last Update Date | 2024-05-16 |