| NPI | 1447605092 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: IL 036149852) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 35C.000757) |
| Enumeration Date | 2016-05-02 |
| Last Update Date | 2023-09-20 |