| NPI | 1043467798 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: IL 125.052698) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX N8551) |
| Enumeration Date | 2008-08-25 |
| Last Update Date | 2023-11-09 |