| NPI | 1033224654 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085001449) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IL 085.001449) |
| Enumeration Date | 2006-08-21 |
| Last Update Date | 2011-02-07 |