| NPI | 1295718781 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: IL 036066295) |
| Additional Taxonomies | 261QM1300X Clinic/Center, Multi-Specialty (Licence: IL 036066295) |
| 207P00000X Emergency Medicine (Licence: IL 036.066295) | |
| Enumeration Date | 2005-11-29 |
| Last Update Date | 2017-02-24 |