| NPI | 1720376718 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: IL 036145520) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 5101019558) |
| 207P00000X Emergency Medicine (Licence: WI 2928-321) | |
| Enumeration Date | 2011-07-12 |
| Last Update Date | 2024-02-29 |