| NPI | 1205567823 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: IL 036175711) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 35.151757) |
| 207P00000X Emergency Medicine (Licence: MI 4351050151) | |
| 207P00000X Emergency Medicine (Licence: IN 01094337A) | |
| Enumeration Date | 2022-06-23 |
| Last Update Date | 2025-08-04 |