| NPI | 1033248208 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: IL 036.117348) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NE 2201) |
| 207P00000X Emergency Medicine (Licence: IA DO-05564) | |
| 207P00000X Emergency Medicine (Licence: CA 20A18682) | |
| Enumeration Date | 2007-03-05 |
| Last Update Date | 2021-07-26 |