| NPI | 1891987194 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NC 2008-00323) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IL 36116439) |
| 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: NC 200800323) | |
| Enumeration Date | 2007-08-10 |
| Last Update Date | 2023-01-26 |