| NPI | 1447224654 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MD D52025) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: DE C1-0009205) |
| 207P00000X Emergency Medicine (Licence: MD D0052025) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: PA MD434633) | |
| Enumeration Date | 2006-02-14 |
| Last Update Date | 2013-01-29 |