| NPI | 1821674763 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0008X Psychiatry & Neurology, Neuromuscular Medicine (Licence: MA 1021992) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MA 1021992) |
| 204C00000X Neuromusculoskeletal Medicine, Sports Medicine (Licence: MA 1021992) | |
| Enumeration Date | 2021-03-22 |
| Last Update Date | 2026-07-01 |