| NPI | 1689194532 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NC 2020-02736) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IL 125.071246) |
| Enumeration Date | 2017-06-21 |
| Last Update Date | 2023-07-06 |