| NPI | 1760693899 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: IL 036.133110) |
| Additional Taxonomies | 204D00000X Neuromusculoskeletal Medicine & OMM (Licence: IL 036.133110) |
| 204D00000X Neuromusculoskeletal Medicine & OMM (Licence: AZ 005202) | |
| 207P00000X Emergency Medicine (Licence: AZ 005202) | |
| 207P00000X Emergency Medicine (Licence: ME 2246) | |
| 207P00000X Emergency Medicine (Licence: IL 036133110) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: AZ R1028) | |
| Enumeration Date | 2007-05-24 |
| Last Update Date | 2021-02-04 |