| NPI | 1134172901 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: AR E-4595) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MO 2008003303) |
| 207P00000X Emergency Medicine (Licence: IL 036.117655) | |
| Enumeration Date | 2006-05-19 |
| Last Update Date | 2009-11-20 |