| NPI | 1174733521 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: IL 036041159) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 258002) |
| 207Q00000X Family Medicine (Licence: IL 036-041159) | |
| 207R00000X Internal Medicine (Licence: IL 036041159) | |
| 208600000X Surgery (Licence: NY 258002) | |
| Enumeration Date | 2007-05-23 |
| Last Update Date | 2020-06-24 |