| NPI | 1356961569 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: IL 125.075547) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WA MD.MD.61391464) |
| 207P00000X Emergency Medicine (Licence: OR MD214413) | |
| Enumeration Date | 2020-04-17 |
| Last Update Date | 2023-05-01 |