| NPI | 1386140366 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MI 4301505121) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IL 036.156099) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2018-03-30 |
| Last Update Date | 2021-07-19 |