| NPI | 1811316334 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: IL 036-143883) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AZ 010251) |
| 207P00000X Emergency Medicine (Licence: WI 68385) | |
| Enumeration Date | 2014-04-11 |
| Last Update Date | 2023-08-03 |