| NPI | 1124132394 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA G156549) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 036091570) |
| Enumeration Date | 2006-08-18 |
| Last Update Date | 2024-08-22 |