| NPI | 1033664149 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 036.169108) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 125077803) |
| Enumeration Date | 2016-08-18 |
| Last Update Date | 2024-05-29 |