| NPI | 1700160959 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: IL 036138535) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IA MD-40817) |
| Enumeration Date | 2011-10-06 |
| Last Update Date | 2017-08-14 |