| NPI | 1194094086 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 036046414) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 336012970) |
| Enumeration Date | 2011-12-21 |
| Last Update Date | 2011-12-21 |