| NPI | 1194964387 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: IL 125052569) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA A111954) |
| 207P00000X Emergency Medicine (Licence: NV 18338) | |
| Enumeration Date | 2009-02-11 |
| Last Update Date | 2025-05-29 |