NPI | 1063553543 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: AZ 43225) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 036113596) |
Enumeration Date | 2007-02-09 |
Last Update Date | 2017-05-01 |