| NPI | 1023278900 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX P0546) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IL 125054665) |
| Enumeration Date | 2008-06-13 |
| Last Update Date | 2014-01-15 |