| NPI | 1861837650 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: IL 036143112) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 284869) |
| 207P00000X Emergency Medicine (Licence: IN 01081815A) | |
| 207P00000X Emergency Medicine (Licence: MO 2019019449) | |
| Enumeration Date | 2013-05-07 |
| Last Update Date | 2019-11-15 |