NPI | 1174714844 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208000000X Pediatrics (Licence: IL 036100091) |
Additional Taxonomies | 171100000X Acupuncturist (Licence: IL 198-000602) |
208D00000X General Practice (Licence: IL 036-100091) | |
Enumeration Date | 2007-08-07 |
Last Update Date | 2021-01-05 |