| NPI | 1144725987 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 036156319) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 125.072392) |
| Enumeration Date | 2018-03-26 |
| Last Update Date | 2021-09-23 |