| NPI | 1124226535 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NV 14346) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 036170328) |
| Enumeration Date | 2007-07-06 |
| Last Update Date | 2024-08-23 |