| NPI | 1578859328 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WI 72797) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IL 036134504) |
| 207P00000X Emergency Medicine (Licence: PA MT200325) | |
| Enumeration Date | 2011-06-21 |
| Last Update Date | 2021-05-14 |