| NPI | 1194987453 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MD D82482) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 036127324) |
| Enumeration Date | 2008-06-27 |
| Last Update Date | 2018-03-03 |