| NPI | 1124104559 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NC 2013-01590) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IL 036-098355) |
| Enumeration Date | 2006-10-27 |
| Last Update Date | 2021-03-29 |