| NPI | 1528084472 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: IL 036-085333) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX J6877) |
| 207P00000X Emergency Medicine (Licence: WI 34824-020) | |
| Enumeration Date | 2006-07-14 |
| Last Update Date | 2015-12-10 |