| 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 |