| NPI | 1821309113 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: IL 036.125422) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 34C.000160) |
| Enumeration Date | 2010-07-01 |
| Last Update Date | 2023-08-28 |