| NPI | 1952711020 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QS0010X Family Medicine, Sports Medicine (Licence: CA A153557) |
| Additional Taxonomies | 207QS0010X Family Medicine, Sports Medicine (Licence: FL ME141714) |
| 207QS0010X Family Medicine, Sports Medicine (Licence: GA MD84343) | |
| 207QS0010X Family Medicine, Sports Medicine (Licence: IL 036150416) | |
| 207QS0010X Family Medicine, Sports Medicine (Licence: MD D0098730) | |
| 207QS0010X Family Medicine, Sports Medicine (Licence: OK 35472) | |
| 207QS0010X Family Medicine, Sports Medicine (Licence: NC 2019-02118) | |
| 207QS0010X Family Medicine, Sports Medicine (Licence: NY 300087-01) | |
| 207QS0010X Family Medicine, Sports Medicine (Licence: RI MD16924) | |
| 207QS0010X Family Medicine, Sports Medicine (Licence: NV 20374) | |
| 207QS0010X Family Medicine, Sports Medicine (Licence: OH 35.136938) | |
| 207QS0010X Family Medicine, Sports Medicine (Licence: AZ 63573) | |
| 207QS0010X Family Medicine, Sports Medicine (Licence: CO Dr.0064465) | |
| 207QS0010X Family Medicine, Sports Medicine (Licence: DC MD048783) | |
| 207QS0010X Family Medicine, Sports Medicine (Licence: TX S3766) | |
| Enumeration Date | 2014-04-29 |
| Last Update Date | 2024-10-23 |