| NPI | 1205959947 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OR MD150308) | 
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IL 036149484) | 
| 207P00000X Emergency Medicine (Licence: WA MD61191514) | |
| 207P00000X Emergency Medicine (Licence: MO 2019032678) | |
| Enumeration Date | 2007-04-09 | 
| Last Update Date | 2025-02-12 |