| NPI | 1356387351 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX N3586) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IL 036-114148) |
| Enumeration Date | 2006-06-20 |
| Last Update Date | 2010-09-24 |