| NPI | 1689820961 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PE0004X Emergency Medicine Emergency Medical Services (Licence: GA 062289) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IL 125049825) |
| Enumeration Date | 2008-08-18 |
| Last Update Date | 2009-08-24 |