| NPI | 1154492312 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 036095243) |
| Additional Taxonomies | 207QA0401X Family Medicine, Addiction Medicine (Licence: IL 036095243) |
| Enumeration Date | 2006-11-10 |
| Last Update Date | 2026-05-18 |