| NPI | 1770744831 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: IL 036.128119) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WI 3111) |
| 207P00000X Emergency Medicine (Licence: PA OT012698) | |
| Enumeration Date | 2008-06-21 |
| Last Update Date | 2025-02-27 |