| NPI | 1659866903 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WA MD61258441) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IL 125073365) |
| Enumeration Date | 2018-06-28 |
| Last Update Date | 2023-10-02 |