| NPI | 1548274343 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: VA 0101042360) |
| Additional Taxonomies | 204C00000X Neuromusculoskeletal Medicine, Sports Medicine (Licence: SC 021585) |
| 207P00000X Emergency Medicine (Licence: SC 14843) | |
| Enumeration Date | 2006-07-28 |
| Last Update Date | 2021-02-27 |