| NPI | 1487825782 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: IL 125050444) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WA MD60011504) |
| Enumeration Date | 2008-03-14 |
| Last Update Date | 2021-04-05 |