| NPI | 1639465115 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: IL 036.143036)  | 
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA A131236)  | 
| 207P00000X Emergency Medicine (Licence: ID M-13202)  | |
| Enumeration Date | 2011-06-23 | 
| Last Update Date | 2023-03-07 |