| NPI | 1225029424 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX M4124) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IL 036-110306) |
| 207P00000X Emergency Medicine (Licence: CA A55342) | |
| Enumeration Date | 2005-11-04 |
| Last Update Date | 2015-11-25 |