| NPI | 1922251982 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PS0010X Emergency Medicine, Sports Medicine (Licence: UT 7153530-1205) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: UT 7153530-1205) |
| 207X00000X Orthopaedic Surgery (Licence: TN MD46150) | |
| Enumeration Date | 2008-11-03 |
| Last Update Date | 2024-08-13 |