| NPI | 1104841949 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OH 34007663) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IL 36111248) |
| 207PT0002X Emergency Medicine, Medical Toxicology (Licence: OH 34-007663) | |
| Enumeration Date | 2006-07-13 |
| Last Update Date | 2012-11-06 |