| NPI | 1891920732 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CT 050617) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IL 125-056142) |
| Enumeration Date | 2009-05-21 |
| Last Update Date | 2013-05-28 |