| NPI | 1851305411 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PE0004X Emergency Medicine Emergency Medical Services (Licence: MI 4301087268) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MI 4301087268) |
| 2085B0100X Radiology Body Imaging (Licence: MI 4301087268) | |
| Enumeration Date | 2006-07-28 |
| Last Update Date | 2024-08-07 |