| NPI | 1467541227 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: IL 085-002044) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA09915) |
| Enumeration Date | 2006-10-12 |
| Last Update Date | 2023-07-28 |