| NPI | 1700225265 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: IL 125-063711) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX Q9980) |
| Enumeration Date | 2013-06-18 |
| Last Update Date | 2023-12-08 |