| NPI | 1215292669 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NM A-2047-17) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IL 125065738) |
| 207P00000X Emergency Medicine (Licence: ID O-1304) | |
| Enumeration Date | 2012-07-11 |
| Last Update Date | 2024-11-18 |