| NPI | 1578906624 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME129796) | 
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IL 036137414) | 
| Enumeration Date | 2013-04-08 | 
| Last Update Date | 2024-11-06 |