| NPI | 1407318934 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: IL 125.074928) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AZ 65988) |
| Enumeration Date | 2019-04-03 |
| Last Update Date | 2026-05-13 |