| NPI | 1497702898 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NM MD2023-1333) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WI 42056-020) |
| 207P00000X Emergency Medicine (Licence: IL 036094168) | |
| Enumeration Date | 2006-05-30 |
| Last Update Date | 2023-11-13 |