| NPI | 1255263166 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: IL 041549756) |
| Additional Taxonomies | 146N00000X Emergency Medical Technician, Basic (Licence: IL 060831211) |
| Enumeration Date | 2026-06-03 |
| Last Update Date | 2026-06-24 |