NPI | 1033290481 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 036-114443) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 036114443) |
Enumeration Date | 2006-10-18 |
Last Update Date | 2021-09-09 |