| NPI | 1548600224 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 036.153861) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA A136965) |
| 207P00000X Emergency Medicine (Licence: CA A136965) | |
| Enumeration Date | 2013-06-26 |
| Last Update Date | 2023-06-21 |