| NPI | 1326612680 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: IL 036.171554) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MO 2025016138) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2021-05-19 |
| Last Update Date | 2025-06-25 |