| NPI | 1346650181 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: IL 036144923) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: GA 75545) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-05-01 |
| Last Update Date | 2018-07-26 |