| NPI | 1306428545 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 335562) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IL 125.077616) |
| Enumeration Date | 2021-04-27 |
| Last Update Date | 2025-05-13 |