| NPI | 1003865403 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: IL 36114380) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 35086927) |
| Enumeration Date | 2006-05-10 |
| Last Update Date | 2024-04-03 |