| NPI | 1972063923 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: MN 75547) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IL 125.073669) |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: MN 33906) | |
| Enumeration Date | 2019-03-24 |
| Last Update Date | 2023-10-26 |