| NPI | 1861417255 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MO R7482) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IL 036-105380) |
| Enumeration Date | 2006-07-13 |
| Last Update Date | 2009-03-02 |