NPI | 1649288705 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2081S0010X Physical Medicine & Rehabilitation, Sports Medicine (Licence: SC 35074) |
Additional Taxonomies | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: SC 35074) |
Enumeration Date | 2006-08-04 |
Last Update Date | 2024-09-24 |