| NPI | 1144362773 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 036-139423) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OK 24556) |
| Enumeration Date | 2007-02-12 |
| Last Update Date | 2023-12-21 |