| NPI | 1295129195 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WA 61225210) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IN 01083732A) |
| 207P00000X Emergency Medicine (Licence: IL 036146303) | |
| 207P00000X Emergency Medicine (Licence: IL 125067401) | |
| Enumeration Date | 2015-03-27 |
| Last Update Date | 2022-03-31 |