| NPI | 1356369383 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PS0010X Emergency Medicine, Sports Medicine (Licence: MD D76157) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NC 2018-03016) |
| 207PS0010X Emergency Medicine, Sports Medicine (Licence: NY 155808) | |
| 2085U0001X Radiology, Diagnostic Ultrasound (Licence: MD D76157) | |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2019-04-05 |