| NPI | 1043564586 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA C195025) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 125062419) |
| Enumeration Date | 2012-11-06 |
| Last Update Date | 2024-08-26 |