| NPI | 1407053895 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: IL 036.119357) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 4301093310) |
| 207P00000X Emergency Medicine (Licence: NV 14479) | |
| Enumeration Date | 2007-06-28 |
| Last Update Date | 2015-04-06 |