| NPI | 1538279567 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WI 20182) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MO 2004004248) |
| 207P00000X Emergency Medicine (Licence: IL 036-106211) | |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2025-04-14 |