| NPI | 1104864842 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WI 38776-020) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IL 036-094801) |
| Enumeration Date | 2006-06-03 |
| Last Update Date | 2009-01-30 |