| NPI | 1184881401 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: IL 036-135932) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IA R-8332) |
| 207P00000X Emergency Medicine (Licence: IA 39124) | |
| 207PS0010X Emergency Medicine, Sports Medicine (Licence: IL 036-135932) | |
| Enumeration Date | 2008-05-22 |
| Last Update Date | 2014-08-19 |