| NPI | 1730593849 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: IL #125-065192) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA A147531) |
| Enumeration Date | 2014-06-17 |
| Last Update Date | 2019-03-26 |