| NPI | 1114332152 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MI 5101021051) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IL 036146479) |
| Enumeration Date | 2014-06-29 |
| Last Update Date | 2026-05-07 |