| NPI | 1013203686 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 036137437) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IN 11016027A) |
| Enumeration Date | 2011-06-22 |
| Last Update Date | 2015-10-15 |