| NPI | 1467883108 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WA OP61123434) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IL 125.062220) |
| Enumeration Date | 2013-12-05 |
| Last Update Date | 2022-02-02 |