| NPI | 1316573926 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: IL 036174045)  | 
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA A186310)  | 
| 207P00000X Emergency Medicine (Licence: CA 5974)  | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2020-03-15 | 
| Last Update Date | 2025-08-04 |