| NPI | 1811456015 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: DC MD210011571) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IL 125.073855) |
| Enumeration Date | 2019-03-18 |
| Last Update Date | 2023-08-30 |