| NPI | 1609003391 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QS0010X Family Medicine, Sports Medicine (Licence: IL 125-057058) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IL 036.124277) |
| Enumeration Date | 2009-06-19 |
| Last Update Date | 2018-05-29 |