| NPI | 1760864730 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: MO 2018016850) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IL 125.067319) |
| Enumeration Date | 2015-06-25 |
| Last Update Date | 2020-10-09 |