| NPI | 1205880978 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: IL 036142815) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WV 30159) |
| 207P00000X Emergency Medicine (Licence: NJ 25MA08015400) | |
| Enumeration Date | 2006-05-19 |
| Last Update Date | 2025-06-05 |