| NPI | 1336119163 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: IL 036-107962) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WI 41520) |
| Enumeration Date | 2006-01-24 |
| Last Update Date | 2021-01-05 |