| NPI | 1649470626 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 060489) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IL 036-117906) |
| Enumeration Date | 2007-07-19 |
| Last Update Date | 2016-08-06 |