| NPI | 1548680754 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 283315) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IL 036.142889) |
| Enumeration Date | 2014-04-27 |
| Last Update Date | 2025-04-30 |