| NPI | 1740675594 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MO 2022005665) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MD462234) |
| 207P00000X Emergency Medicine (Licence: IL 036.148091) | |
| Enumeration Date | 2015-03-30 |
| Last Update Date | 2022-11-02 |