| NPI | 1619048733 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RS0010X Internal Medicine, Sports Medicine (Licence: HI 7993) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: HI MD7993) |
| Enumeration Date | 2006-11-11 |
| Last Update Date | 2015-12-11 |