| NPI | 1629310842 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: IL 036-145620) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AZ 51387) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2013-03-26 |
| Last Update Date | 2024-10-15 |