| NPI | 1558755587 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: IL 036160015) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 036160015) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 207P00000X Emergency Medicine (Licence: IL 036160015) | |
| Enumeration Date | 2015-03-27 |
| Last Update Date | 2026-07-22 |