| NPI | 1710125976 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: IL 036124947) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WI 73971) |
| 261QI0500X Clinic/Center, Infusion Therapy (Licence: IL 036124947) | |
| 207P00000X Emergency Medicine (Licence: IL 125052864) | |
| Enumeration Date | 2009-01-27 |
| Last Update Date | 2024-04-29 |