| NPI | 1124082367 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: SC 10017) |
| Additional Taxonomies | 207U00000X Nuclear Medicine (Licence: SC 10017) |
| Enumeration Date | 2006-04-14 |
| Last Update Date | 2023-03-07 |