| NPI | 1306165071 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: IL 036151901) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA 20A16621) |
| 207P00000X Emergency Medicine (Licence: NY 270176) | |
| 207P00000X Emergency Medicine (Licence: IN 02006933A) | |
| Enumeration Date | 2010-05-20 |
| Last Update Date | 2022-09-14 |