| NPI | 1124004908 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: MI 5101011995) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IL 036146433) |
| Enumeration Date | 2005-12-22 |
| Last Update Date | 2019-01-18 |