| NPI | 1063472405 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 036-118646) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IL 036-118646) |
| 207P00000X Emergency Medicine (Licence: IA 35460) | |
| Enumeration Date | 2006-03-27 |
| Last Update Date | 2023-06-30 |