| NPI | 1700380128 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA A202405) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IL 125.072283) |
| Enumeration Date | 2018-03-20 |
| Last Update Date | 2025-05-22 |