| NPI | 1306223185 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MA 278067) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IL 125.068518) |
| 207P00000X Emergency Medicine (Licence: CO DR.0067828) | |
| Enumeration Date | 2015-04-30 |
| Last Update Date | 2025-05-09 |