| NPI | 1407295223 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: IL 125-062887) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 299114) |
| Enumeration Date | 2013-06-14 |
| Last Update Date | 2026-02-23 |