| NPI | 1306879143 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NC 200200645) |
| Additional Taxonomies | 207PT0002X Emergency Medicine, Medical Toxicology (Licence: NC 200200645) |
| 2085U0001X Radiology, Diagnostic Ultrasound (Licence: NC 200200645) | |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2022-04-08 |