| NPI | 1003279985 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 327856) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IL 036-161873) |
| Enumeration Date | 2016-03-30 |
| Last Update Date | 2026-04-13 |