in - Neuromusculoskeletal Medicine, Sports Medicine

- NPI 1740330059

is a Neuromusculoskeletal Medicine, Sports Medicine in , . practices all healthcare services and medical treatments related to Neuromusculoskeletal Medicine, Sports Medicine. The NPI Number for is 1740330059. The last update date is .

's current location address is , , . You can contact this provider via phone number . The mailing address for is , , . To know further, please read the information below!

Provider Profile Detail

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Sole Proprietor	--
Credentials	--

NPI Number Detail

NPI Number	1740330059
Provider Enumeration Date
Last Updated Date

Provider Mailing Address Detail

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Provider's Primary Taxonomy Detail

Speciality	Neuromusculoskeletal Medicine, Sports Medicine
Taxonomy	204C00000X
Licence No	203132
Definition: A Neuromusculoskeletal Medicine and Osteopathic Manipulative Medicine physician trained to be responsible for the continuous care in the field of sports medicine encompasses increased knowledge and understanding of osteopathic principles and practice

Provider's Other Legacy Identifiers

Identifier	Identifier Type	Identifier State	Identifier Issuer
2086428		NY	--

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