| NPI | 1154819712 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 310345) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IL 125-072115) |
| Enumeration Date | 2018-04-28 |
| Last Update Date | 2021-07-01 |