| NPI | 1154455210 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 036-096053) |
| Additional Taxonomies | 208D00000X General Practice (Licence: IL 036096053) |
| Enumeration Date | 2007-03-14 |
| Last Update Date | 2025-02-25 |