| NPI | 1164504874 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: IL 036-109183) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 036109183) |
| 208600000X Surgery (Licence: IL 036109183) | |
| Enumeration Date | 2006-10-20 |
| Last Update Date | 2020-05-18 |