| 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 |