| NPI | 1033364849 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 036.134907) |
| Additional Taxonomies | 207QA0505X Family Medicine, Adult Medicine (Licence: IL 036.134907) |
| 207QS0010X Family Medicine, Sports Medicine (Licence: IL 036.134907) | |
| Enumeration Date | 2008-11-20 |
| Last Update Date | 2016-09-02 |