| NPI | 1356333991 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: IL 036-058944) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WI 39679-021) |
| Enumeration Date | 2005-08-19 |
| Last Update Date | 2007-07-08 |