| NPI | 1609130327 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: VA 0101273732) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IL 125-062179) |
| Enumeration Date | 2012-06-27 |
| Last Update Date | 2022-01-21 |