| NPI | 1033645023 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 036.153237) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 1033645023) |
| Enumeration Date | 2017-05-11 |
| Last Update Date | 2021-08-12 |