| NPI | 1235370743 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: IL 085003431) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IL 085003431) |
| Enumeration Date | 2009-03-12 |
| Last Update Date | 2013-01-03 |