| NPI | 1356481048 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MO 2004003089) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IL 036-092349) |
| Enumeration Date | 2007-02-08 |
| Last Update Date | 2007-07-08 |