| NPI | 1023509320 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MO 2026012077) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IL 036156229) |
| Enumeration Date | 2018-05-22 |
| Last Update Date | 2026-05-08 |