| NPI | 1922233279 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: IL 036.132627) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL UO2108) |
| 207P00000X Emergency Medicine (Licence: GA 66877) | |
| 207P00000X Emergency Medicine (Licence: CA 20A14048) | |
| Enumeration Date | 2009-05-15 |
| Last Update Date | 2019-03-22 |