| NPI | 1972643948 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WI 38098-020) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WI 38098-20) |
| 207P00000X Emergency Medicine (Licence: IN 01064325A) | |
| 207P00000X Emergency Medicine (Licence: IL 036-098742) | |
| Enumeration Date | 2007-02-07 |
| Last Update Date | 2020-12-02 |