| NPI | 1033134267 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA OP60219951) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 036109991) |
| Enumeration Date | 2006-07-12 |
| Last Update Date | 2024-01-16 |