| NPI | 1558468330 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: IL 036-070709) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA G71154) |
| 207P00000X Emergency Medicine (Licence: NC 0093-00176) | |
| 207P00000X Emergency Medicine (Licence: MD D30039) | |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2007-07-08 |