| NPI | 1861027625 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207PS0010X Emergency Medicine, Sports Medicine (Licence: NV 0506428) |
| Additional Taxonomies | 174H00000X Health Educator (Licence: NV 0506428) |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: NV 0506428) | |
| 208100000X Physical Medicine & Rehabilitation (Licence: NV 0506428) | |
| 226300000X Kinesiotherapist (Licence: NV 0506428) | |
| 405300000X Prevention Professional (Licence: NV 0506428) | |
| Enumeration Date | 2020-03-11 |
| Last Update Date | 2020-03-11 |