NPI | 1942728167 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2083S0010X Preventive Medicine, Sports Medicine (Licence: CO AT.0001864) |
Additional Taxonomies | 2083S0010X Preventive Medicine, Sports Medicine (Licence: KS 24-01217) |
Enumeration Date | 2017-09-08 |
Last Update Date | 2022-09-18 |