| NPI | 1013203314 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 036134782) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: ID O-1414) |
| Enumeration Date | 2011-06-24 |
| Last Update Date | 2022-12-29 |