NPI | 1952666091 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: NC 2016-02257) |
Additional Taxonomies | 207RS0010X Internal Medicine, Sports Medicine (Licence: NC 2016-02257) |
Enumeration Date | 2012-07-04 |
Last Update Date | 2023-09-02 |