| NPI | 1992797922 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RS0010X Internal Medicine, Sports Medicine (Licence: KY 36283) |
| Additional Taxonomies | 204C00000X Neuromusculoskeletal Medicine, Sports Medicine (Licence: OH 35065311S) |
| 207RH0002X Internal Medicine, Hospice and Palliative Medicine (Licence: OH 35-0653115) | |
| Enumeration Date | 2005-08-16 |
| Last Update Date | 2021-08-03 |