| NPI | 1649470204 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WI 54561-20) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MN 51841) |
| 207P00000X Emergency Medicine (Licence: IL 036159388) | |
| Enumeration Date | 2007-07-23 |
| Last Update Date | 2022-03-18 |