| NPI | 1790226900 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: IL 036.150694) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IL 125.070476) |
| Enumeration Date | 2017-03-20 |
| Last Update Date | 2025-08-04 |