| NPI | 1942245147 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: IL 36.047148) |
| Additional Taxonomies | 173000000X Legal Medicine (Licence: IL 36-47148) |
| 207R00000X Internal Medicine (Licence: IL 036.047148) | |
| Enumeration Date | 2006-06-19 |
| Last Update Date | 2020-04-01 |