NPI | 1427390137 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207RS0010X Internal Medicine Sports Medicine (Licence: FL ME128315) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME128315) |
Enumeration Date | 2013-03-20 |
Last Update Date | 2022-03-17 |