| NPI | 1346655297 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MI 5101021045) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MI 5101021045) |
| 2085B0100X Radiology, Body Imaging (Licence: MI 5101021045) | |
| Enumeration Date | 2014-06-29 |
| Last Update Date | 2025-02-21 |