| NPI | 1073213559 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2471C3402X Radiologic Technologist Radiography (Licence: CA 561437) |
| Additional Taxonomies | 207PE0004X Emergency Medicine Emergency Medical Services (Licence: CA 562437) |
| 207Q00000X Family Medicine (Licence: CA 562437) | |
| 207XX0004X Orthopaedic Surgery Foot and Ankle Surgery (Licence: CA 562437) | |
| 2085B0100X Radiology Body Imaging (Licence: CA 562437) | |
| 2085H0002X Radiology Hospice and Palliative Medicine (Licence: CA 562437) | |
| Enumeration Date | 2023-03-03 |
| Last Update Date | 2023-04-21 |