| NPI | 1225652530 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME166609) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IL 125.076905) |
| Enumeration Date | 2020-06-02 |
| Last Update Date | 2024-07-08 |