| NPI | 1821292400 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0700X (Licence: ND 18693) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX M7518) |
| 2085N0700X (Licence: TX M7518) | |
| 2085N0700X (Licence: AZ 55343) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: TX M7518) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: WI 2454-320) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MI EMC0005689) | |
| 208D00000X General Practice (Licence: TX M7518) | |
| Enumeration Date | 2007-06-14 |
| Last Update Date | 2025-02-24 |