| NPI | 1730876731 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WI 82208-021) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IL 128.082888) |
| Enumeration Date | 2023-04-19 |
| Last Update Date | 2026-07-28 |