| NPI | 1215292933 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: IL 036.143211) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MO 2012023082) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2012-07-09 |
| Last Update Date | 2017-07-25 |