| NPI | 1982863429 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: AZ 005782) |
| Additional Taxonomies | 208600000X Surgery (Licence: TX 390200000x) |
| 208600000X Surgery (Licence: IL 036139212) | |
| Enumeration Date | 2008-06-09 |
| Last Update Date | 2017-05-31 |