| NPI | 1477304350 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA A210643) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A210643) |
| Enumeration Date | 2024-03-29 |
| Last Update Date | 2026-07-23 |