| NPI | 1225022718 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: MO 2013002805) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IL 036095900) |
| 207Q00000X Family Medicine (Licence: IL 036095900) | |
| 207Q00000X Family Medicine (Licence: MO 2013002805) | |
| 207Q00000X Family Medicine (Licence: IN 01069387A) | |
| 207Q00000X Family Medicine (Licence: TX P6438) | |
| Enumeration Date | 2005-09-09 |
| Last Update Date | 2023-03-23 |