NPI | 1477135614 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207PS0010X Emergency Medicine, Sports Medicine (Licence: AZ 77231) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AZ 77231) |
Enumeration Date | 2021-04-27 |
Last Update Date | 2025-09-09 |