| NPI | 1902120819 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: IL 036.134694) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MO 2012023819) |
| Enumeration Date | 2010-03-22 |
| Last Update Date | 2024-10-18 |