| NPI | 1801381868 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: IL 036159067) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 308914) |
| 207P00000X Emergency Medicine (Licence: MI 4301115517) | |
| Enumeration Date | 2018-06-22 |
| Last Update Date | 2022-06-01 |