| NPI | 1407894884 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: NY 136042) |
| Additional Taxonomies | 2085R0203X Radiology, Therapeutic Radiology (Licence: NY 136042) |
| Enumeration Date | 2006-06-04 |
| Last Update Date | 2007-07-08 |