| NPI | 1023035573 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: IL 036-079250) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MO 2002031637) |
| 207P00000X Emergency Medicine (Licence: NC 9900480) | |
| 207P00000X Emergency Medicine (Licence: TX J5749) | |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2020-03-23 |