| NPI | 1124441753 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: IL 036144869) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX S2420) |
| 207P00000X Emergency Medicine (Licence: NY 287900) | |
| 207P00000X Emergency Medicine (Licence: IN 01081734A) | |
| 207P00000X Emergency Medicine (Licence: MO 2019016873) | |
| Enumeration Date | 2014-02-03 |
| Last Update Date | 2019-11-18 |