| NPI | 1386083335 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WI 65720) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IL 125.063483) |
| Enumeration Date | 2013-06-21 |
| Last Update Date | 2018-05-09 |