| NPI | 1487115408 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: IL 036.166390) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA A180328) |
| 207P00000X Emergency Medicine (Licence: MO 2023022091) | |
| Enumeration Date | 2019-03-31 |
| Last Update Date | 2023-11-03 |