| NPI | 1821102781 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: IL 036-114151) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OK 24448) |
| Enumeration Date | 2006-08-18 |
| Last Update Date | 2024-02-19 |