| NPI | 1003078072 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: IL 036.130277)  | 
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CT 050264)  | 
| Enumeration Date | 2008-06-30 | 
| Last Update Date | 2022-09-14 |