NPI | 1194749218 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 036059275) |
Additional Taxonomies | 207QA0000X Family Medicine, Adolescent Medicine (Licence: IL 036059275) |
207QA0505X Family Medicine, Adult Medicine (Licence: IL 036059275) | |
Enumeration Date | 2006-07-26 |
Last Update Date | 2024-08-28 |