| NPI | 1114906468 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WI 84376) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IL 036174155) |
| 207R00000X Internal Medicine (Licence: FL ME0085124) | |
| 207R00000X Internal Medicine (Licence: KS 04-49153) | |
| Enumeration Date | 2006-01-14 |
| Last Update Date | 2025-08-11 |