| NPI | 1003200114 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX S4905) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IL 036.145043) |
| 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: TX S4905) | |
| Enumeration Date | 2015-03-26 |
| Last Update Date | 2023-06-07 |