| NPI | 1841877222 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA 20A23675) | 
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IL 125.078109) | 
| 207P00000X Emergency Medicine (Licence: IL 036.167218) | |
| Enumeration Date | 2021-03-24 | 
| Last Update Date | 2025-06-03 |