| NPI | 1679669691 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: AZ 35799) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IL 036.122086) |
| Enumeration Date | 2006-10-05 |
| Last Update Date | 2022-02-11 |