| NPI | 1497119622 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WA 60970818) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IL 036167690) |
| Enumeration Date | 2016-04-13 |
| Last Update Date | 2024-12-10 |