| NPI | 1841276847 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 261QU0200X Clinic/Center, Urgent Care (Licence: IL 036-093222) |
| Additional Taxonomies | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: IL 36093222) |
| 2083X0100X Preventive Medicine, Occupational Medicine (Licence: IL 036-093222) | |
| 207P00000X Emergency Medicine (Licence: IL 036-093222) | |
| 261QX0100X Clinic/Center, Occupational Medicine (Licence: IL 036-093222) | |
| Enumeration Date | 2005-12-21 |
| Last Update Date | 2014-04-23 |