| NPI | 1083861843 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX N8556) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IL 125052439) |
| Enumeration Date | 2008-08-24 |
| Last Update Date | 2021-12-16 |