| NPI | 1114933686 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: IL 036.151179) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TN 52521) |
| 207P00000X Emergency Medicine (Licence: KY 38150) | |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2021-09-07 |