| NPI | 1205959947 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: IL 036149484) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OR MD150308) |
| 207P00000X Emergency Medicine (Licence: MO 2019032678) | |
| 207P00000X Emergency Medicine (Licence: WA MD61191514) | |
| Enumeration Date | 2007-04-09 |
| Last Update Date | 2022-03-18 |