| NPI | 1558372417 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NH 8790) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IL 036-087343) |
| Enumeration Date | 2006-08-10 |
| Last Update Date | 2011-09-15 |