| NPI | 1871243279 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TN 73431) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IL 1234) |
| Enumeration Date | 2022-03-28 |
| Last Update Date | 2026-06-29 |