| NPI | 1053403840 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 228480) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IL 036162899) |
| Enumeration Date | 2006-09-29 |
| Last Update Date | 2025-03-05 |