| NPI | 1508251109 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: IL 036.145530) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WI 66193-20) |
| Enumeration Date | 2015-03-31 |
| Last Update Date | 2022-11-03 |