| NPI | 1477281954 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2081S0010X Physical Medicine & Rehabilitation, Sports Medicine (Licence: TN 2081S0010X) |
| Additional Taxonomies | 204C00000X Neuromusculoskeletal Medicine, Sports Medicine (Licence: TN 204C00000X) |
| 207PS0010X Emergency Medicine, Sports Medicine (Licence: TN 207PS0010X) | |
| 2083S0010X Preventive Medicine, Sports Medicine (Licence: TN 2083S0010X) | |
| 2084S0010X Psychiatry & Neurology, Sports Medicine (Licence: TN 2084S0010X) | |
| Enumeration Date | 2022-08-11 |
| Last Update Date | 2024-12-12 |