| NPI | 1912092818 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TN 4498) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IL 036133723) |
| 207P00000X Emergency Medicine (Licence: MO 2005001991) | |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2021-10-05 |