NPI | 1790978260 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207P00000X Emergency Medicine (Licence: IA MD-47539) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WI 53924-020) |
207P00000X Emergency Medicine (Licence: IL 036.122864) | |
207P00000X Emergency Medicine (Licence: IL 125050679) | |
Enumeration Date | 2007-08-19 |
Last Update Date | 2021-11-29 |