| NPI | 1700853140 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 036050468) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IL 036-050468) |
| Enumeration Date | 2006-03-03 |
| Last Update Date | 2022-04-08 |