| NPI | 1831570431 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: KY 57146) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IL 036144143) |
| 207P00000X Emergency Medicine (Licence: IL 125-067265) | |
| 207P00000X Emergency Medicine (Licence: CO DR.0061594) | |
| Enumeration Date | 2015-06-09 |
| Last Update Date | 2022-09-20 |