| NPI | 1972739431 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: IL 125-056738) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: KY 60289) |
| Enumeration Date | 2009-06-10 |
| Last Update Date | 2025-03-12 |