| NPI | 1891948568 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA A105872) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IL 036.127730) |
| Enumeration Date | 2008-10-28 |
| Last Update Date | 2011-07-16 |