| NPI | 1952788796 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: IL 036144308) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WI 70721-21) |
| 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: WI 70721-21) | |
| Enumeration Date | 2015-04-30 |
| Last Update Date | 2026-02-23 |