| NPI | 1730507575 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA A171028) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IL 036.156862) |
| 207P00000X Emergency Medicine (Licence: WI 83189-20) | |
| 207P00000X Emergency Medicine (Licence: IL 036156862) | |
| Enumeration Date | 2014-03-30 |
| Last Update Date | 2025-08-25 |