| NPI | 1154617058 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MA 258476) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IL 125-059970) |
| Enumeration Date | 2011-06-20 |
| Last Update Date | 2025-03-13 |