| NPI | 1700191509 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MI 4301505141) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IL 125-058465) |
| Enumeration Date | 2010-08-17 |
| Last Update Date | 2021-09-09 |