| NPI | 1639113889 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NC 200600234) |
| Additional Taxonomies | 2085U0001X Radiology, Diagnostic Ultrasound (Licence: NC 200600234) |
| Enumeration Date | 2006-06-16 |
| Last Update Date | 2011-09-09 |