| NPI | 1316576846 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WA OP61361059) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IL 125.075691) |
| Enumeration Date | 2020-04-06 |
| Last Update Date | 2023-06-24 |