| NPI | 1104180173 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: IL 125061421) | 
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IL 036136480) | 
| Enumeration Date | 2012-06-25 | 
| Last Update Date | 2023-05-23 |