| NPI | 1104355304 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CO DR0063650) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IL 125070249) |
| Enumeration Date | 2017-06-09 |
| Last Update Date | 2022-11-07 |