| NPI | 1851885438 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PS0010X Emergency Medicine, Sports Medicine (Licence: CO DR.0069063) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NE 34773) |
| 207Q00000X Family Medicine (Licence: OK 38085) | |
| 207RS0010X Internal Medicine, Sports Medicine (Licence: NE 34773) | |
| Enumeration Date | 2018-06-18 |
| Last Update Date | 2025-07-24 |