| NPI | 1356543706 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MO 2011032953) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IL 125-051081) |
| Enumeration Date | 2007-06-05 |
| Last Update Date | 2013-05-17 |