| NPI | 1477574739 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: MI 4301063534) |
| Additional Taxonomies | 207PE0005X Emergency Medicine, Undersea and Hyperbaric Medicine (Licence: MI 4301063534) |
| 207L00000X Anesthesiology (Licence: MI 4301063534) | |
| 2085B0100X Radiology, Body Imaging (Licence: MI 4301063534) | |
| Enumeration Date | 2006-07-22 |
| Last Update Date | 2024-12-12 |