| NPI | 1316320112 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 298929) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IL 125067314) |
| Enumeration Date | 2015-06-30 |
| Last Update Date | 2025-08-01 |