| NPI | 1598893679 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NC 19838) |
| Additional Taxonomies | 2085U0001X Radiology, Diagnostic Ultrasound (Licence: NC 19838) |
| Enumeration Date | 2007-03-01 |
| Last Update Date | 2007-12-06 |