| NPI | 1730561747 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: IL 036.146658) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IL 125066908) |
| 207P00000X Emergency Medicine (Licence: IN 01081643A) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: IL 125.066908) | |
| Enumeration Date | 2015-06-25 |
| Last Update Date | 2023-03-10 |