| NPI | 1518151968 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA A103150) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IL 125047692) |
| Enumeration Date | 2007-08-29 |
| Last Update Date | 2012-09-19 |