| NPI | 1134567084 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MO 2016009046) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IL 125.062947) |
| Enumeration Date | 2013-06-12 |
| Last Update Date | 2023-09-11 |