| NPI | 1104189620 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA 141549) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IL 125-060903) |
| Enumeration Date | 2012-06-19 |
| Last Update Date | 2017-02-22 |