| NPI | 1811089238 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RS0010X Internal Medicine, Sports Medicine (Licence: TN DO01195) |
| Additional Taxonomies | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: TN DO01195) |
| 2081S0010X Physical Medicine & Rehabilitation, Sports Medicine (Licence: TN DO01195) | |
| 207R00000X Internal Medicine (Licence: TN 01195) | |
| Enumeration Date | 2006-09-30 |
| Last Update Date | 2020-10-15 |