| NPI | 1982346839 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WI 87753-020) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IL 036172325) |
| Enumeration Date | 2022-04-11 |
| Last Update Date | 2026-08-04 |