| NPI | 1790929693 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WI 61892-20) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IL 036-129297) |
| Enumeration Date | 2009-04-23 |
| Last Update Date | 2014-02-26 |