| NPI | 1063808079 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: IL 036.154248) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MA 278200) |
| 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: IL 036.154248) | |
| Enumeration Date | 2015-04-07 |
| Last Update Date | 2021-12-01 |