| NPI | 1609893213 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: IL 036-070960) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IN 01040022A) |
| 207P00000X Emergency Medicine (Licence: WI 35430) | |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2008-02-07 |