| NPI | 1548556715 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: IL 125060136) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL ME132116) |
| Enumeration Date | 2011-06-25 |
| Last Update Date | 2025-06-18 |