| NPI | 1790042067 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: IL 036136113) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: KS 04-37987) |
| 207P00000X Emergency Medicine (Licence: IN 01081835A) | |
| Enumeration Date | 2012-04-11 |
| Last Update Date | 2019-03-04 |