| NPI | 1811302854 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WI 67192.21) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IL 125.06984) |
| Enumeration Date | 2014-06-28 |
| Last Update Date | 2018-03-17 |