| NPI | 1780211573 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: DC DO210001759) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IL 125.076235) |
| Enumeration Date | 2020-03-24 |
| Last Update Date | 2025-04-30 |