| NPI | 1821730987 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MN 78539) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IL 036172597) |
| Enumeration Date | 2022-04-10 |
| Last Update Date | 2025-12-08 |