| NPI | 1568559698 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PS0010X Emergency Medicine, Sports Medicine (Licence: TN 38345) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TN MD38345) |
| 207RS0010X Internal Medicine, Sports Medicine (Licence: TN MD38345) | |
| Enumeration Date | 2006-10-09 |
| Last Update Date | 2024-09-12 |