| NPI | 1316083124 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME131797) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IL 036097523) |
| Enumeration Date | 2007-01-29 |
| Last Update Date | 2020-02-14 |