| NPI | 1619328895 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: IL 125.068921) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MO 2019026354) |
| Enumeration Date | 2016-06-28 |
| Last Update Date | 2019-11-18 |