| NPI | 1063488401 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MO r2c68) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MO R2C68) |
| 207P00000X Emergency Medicine (Licence: IL 036106713) | |
| Enumeration Date | 2006-02-26 |
| Last Update Date | 2020-02-19 |