| NPI | 1801390893 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 125.073118) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA A185154) |
| Enumeration Date | 2018-03-22 |
| Last Update Date | 2025-02-12 |