| NPI | 1972729291 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: IL 036123116) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 35.090710) |
| Enumeration Date | 2007-04-17 |
| Last Update Date | 2025-11-25 |