| NPI | 1609257609 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MA 274195) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IL 125066914) |
| Enumeration Date | 2015-06-16 |
| Last Update Date | 2019-02-22 |