| NPI | 1043220742 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: IL 036047145) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IL 036047145) |
| Enumeration Date | 2006-08-08 |
| Last Update Date | 2016-09-27 |