| 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 |