| NPI | 1578719480 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX P8389) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IL 125050697) |
| Enumeration Date | 2008-08-12 |
| Last Update Date | 2023-11-07 |