| NPI | 1306304688 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX T1192) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IL 036.159032) |
| Enumeration Date | 2019-03-06 |
| Last Update Date | 2025-10-06 |