| NPI | 1902064702 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MI 4301097390) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IL 125054140) |
| Enumeration Date | 2008-05-28 |
| Last Update Date | 2012-07-10 |