| NPI | 1780886952 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MD D0073251) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IL 36118543) |
| 207P00000X Emergency Medicine (Licence: NY 261121) | |
| Enumeration Date | 2007-06-01 |
| Last Update Date | 2011-12-04 |