| NPI | 1376539700 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: KY C0548) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IL 036019519) |
| 207P00000X Emergency Medicine (Licence: IL 036109519) | |
| 207R00000X Internal Medicine (Licence: WI 916) | |
| 207RA0000X Internal Medicine, Adolescent Medicine (Licence: IL 036109519) | |
| Enumeration Date | 2005-09-21 |
| Last Update Date | 2023-08-03 |