| NPI | 1114148665 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: IL 036115005) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MO 2005034467) |
| 207P00000X Emergency Medicine (Licence: KY 19127) | |
| 207P00000X Emergency Medicine (Licence: MS 19653) | |
| Enumeration Date | 2007-05-01 |
| Last Update Date | 2007-07-08 |