| NPI | 1053739086 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OH 35.133280) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IL Training) |
| Enumeration Date | 2014-04-07 |
| Last Update Date | 2018-07-06 |