| NPI | 1508896903 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NC 2005-01146) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NC 200501146) |
| 207P00000X Emergency Medicine (Licence: IN 01041556A) | |
| 207PP0204X Emergency Medicine, Pediatric Emergency Medicine (Licence: NC 2005-01146) | |
| 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: NC 2005-01146) | |
| 2085U0001X Radiology, Diagnostic Ultrasound (Licence: NC 2005-01146) | |
| Enumeration Date | 2006-07-03 |
| Last Update Date | 2022-11-03 |