| NPI | 1740268648 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 03679529) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IL 03679529) |
| Enumeration Date | 2006-01-03 |
| Last Update Date | 2021-02-18 |