| NPI | 1245458454 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 60 252700) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IL 036119361) |
| Enumeration Date | 2007-04-23 |
| Last Update Date | 2023-05-24 |