| NPI | 1053554915 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CO DR51509) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 036169377) |
| Enumeration Date | 2009-04-08 |
| Last Update Date | 2024-04-30 |