| NPI | 1770500233 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: IL 036-109172) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 35-062896 B) |
| 207P00000X Emergency Medicine (Licence: CT 030180) | |
| 207P00000X Emergency Medicine (Licence: DE C10003153) | |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2015-01-29 |