| NPI | 1326797267 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OH 35.154536) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IL 125.079364) |
| Enumeration Date | 2022-03-19 |
| Last Update Date | 2026-05-19 |