| NPI | 1245346626 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: IL 036-108258) | 
| Additional Taxonomies | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: CA A88069) | 
| Enumeration Date | 2006-08-21 | 
| Last Update Date | 2021-12-09 |