| NPI | 1477785145 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PS0010X Emergency Medicine, Sports Medicine (Licence: NJ 25MA08828600) |
| Additional Taxonomies | 204C00000X Neuromusculoskeletal Medicine, Sports Medicine (Licence: FL ME120474) |
| 207PS0010X Emergency Medicine, Sports Medicine (Licence: NY 254381-1) | |
| Enumeration Date | 2009-08-14 |
| Last Update Date | 2023-12-29 |