| NPI | 1063856979 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: IL 036-144024) |
| Additional Taxonomies | 207PS0010X Emergency Medicine, Sports Medicine (Licence: IL 036-144024) |
| Enumeration Date | 2013-04-22 |
| Last Update Date | 2022-06-27 |