| NPI | 1134174758 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: IL 036050009) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 036050009) |
| 208D00000X General Practice (Licence: IL 036050009) | |
| 207Q00000X Family Medicine (Licence: IL 036050009) | |
| Enumeration Date | 2006-05-23 |
| Last Update Date | 2019-01-21 |