| NPI | 1801072145 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX P8350) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IL 036-116748) |
| Enumeration Date | 2008-01-16 |
| Last Update Date | 2014-06-02 |