| NPI | 1790922011 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: KY 42878) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IL 036122205) |
| Enumeration Date | 2009-01-08 |
| Last Update Date | 2015-06-08 |