| NPI | 1821254624 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CT 052303) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IL 036.126773) |
| 207P00000X Emergency Medicine (Licence: PA MD438128) | |
| Enumeration Date | 2008-07-31 |
| Last Update Date | 2013-10-04 |