| NPI | 1881013191 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PS0010X Emergency Medicine, Sports Medicine (Licence: FL ME133479) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CO DR.0064024) |
| 207PS0010X Emergency Medicine, Sports Medicine (Licence: CO DR.0064024) | |
| 207PS0010X Emergency Medicine, Sports Medicine (Licence: VA 0101259311) | |
| Enumeration Date | 2014-04-15 |
| Last Update Date | 2022-09-26 |