| NPI | 1174548549 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MO 105483) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL ME83088) |
| 207P00000X Emergency Medicine (Licence: MO 105483) | |
| 207P00000X Emergency Medicine (Licence: IL 036-094350) | |
| Enumeration Date | 2006-07-13 |
| Last Update Date | 2022-02-09 |