| NPI | 1184286106 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MI 5101026292) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MI 5101026292) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MI 5101026292) | |
| Enumeration Date | 2019-06-29 |
| Last Update Date | 2025-05-19 |