| NPI | 1033157292 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208D00000X General Practice (Licence: IL 036051469) |
| Additional Taxonomies | 208600000X Surgery (Licence: IL 036051469) |
| Enumeration Date | 2006-06-02 |
| Last Update Date | 2011-03-25 |