| NPI | 1194089813 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA A149314) | 
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IL 125-061539) | 
| Enumeration Date | 2012-06-27 | 
| Last Update Date | 2018-03-17 |