| NPI | 1760790802 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MO 2021038583) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IL 125-057482) |
| Enumeration Date | 2010-09-23 |
| Last Update Date | 2022-09-20 |