| NPI | 1518321165 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RS0010X Internal Medicine Sports Medicine (Licence: PA OS023452) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: RI DO01053) |
| 207R00000X Internal Medicine (Licence: PA OS023452) | |
| 207RS0010X Internal Medicine Sports Medicine (Licence: RI DO01053) | |
| Enumeration Date | 2016-04-11 |
| Last Update Date | 2024-05-06 |