| NPI | 1275754475 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 239764) |
| Additional Taxonomies | 2085U0001X Radiology, Diagnostic Ultrasound (Licence: NY 239764) |
| Enumeration Date | 2007-05-02 |
| Last Update Date | 2021-11-19 |