| NPI | 1962486274 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 036095861) |
| Additional Taxonomies | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: IL 036095861) |
| Enumeration Date | 2005-11-30 |
| Last Update Date | 2021-12-16 |