| NPI | 1104387893 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 036-160995) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 1104387893) |
| Enumeration Date | 2019-03-26 |
| Last Update Date | 2022-10-28 |