| NPI | 1649365529 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 036116733) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IL 036-116733) |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2020-10-13 |