| NPI | 1356874838 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MI 4301501548) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MI 4301501548) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MI 4301501548) | |
| Enumeration Date | 2017-04-11 |
| Last Update Date | 2025-05-19 |