| NPI | 1588225056 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PS0010X Emergency Medicine, Sports Medicine (Licence: NE 2807) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NE 8585) |
| 207PS0010X Emergency Medicine, Sports Medicine (Licence: IA DO-06437) | |
| 207P00000X Emergency Medicine (Licence: NE 2807) | |
| Enumeration Date | 2019-06-25 |
| Last Update Date | 2024-03-28 |