| NPI | 1902485238 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME160753) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IL 036167033) |
| Enumeration Date | 2021-04-05 |
| Last Update Date | 2025-07-17 |