| NPI | 1326276072 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA A119814)  | 
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IL 036-139374)  | 
| Enumeration Date | 2009-07-01 | 
| Last Update Date | 2019-08-22 |