| NPI | 1710320189 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: IL 036.140300) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 036.140300) | 
| Enumeration Date | 2013-04-16 | 
| Last Update Date | 2019-02-27 |