| NPI | 1275021008 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CO 0066258) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IL 125.071684) |
| Enumeration Date | 2018-04-26 |
| Last Update Date | 2021-08-03 |