NPI | 1437221322 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: WV 22568) |
Additional Taxonomies | 207RS0010X Internal Medicine Sports Medicine (Licence: WV 22568) |
207XX0005X Orthopaedic Surgery Sports Medicine (Licence: WV 22568) | |
Enumeration Date | 2006-11-15 |
Last Update Date | 2022-04-18 |