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 |