| NPI | 1487093795 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PE0004X Emergency Medicine Emergency Medical Services (Licence: WI 65681-21) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IL 125.062920) |
| 207PE0004X Emergency Medicine Emergency Medical Services (Licence: IL 036-139276) | |
| Enumeration Date | 2013-06-19 |
| Last Update Date | 2016-06-16 |