| NPI | 1417103490 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: IL 125-050807) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WA MD60139748) |
| Enumeration Date | 2008-08-11 |
| Last Update Date | 2023-07-21 |