| NPI | 1215021100 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 036077426) |
| Additional Taxonomies | 207QA0401X Family Medicine, Addiction Medicine (Licence: IL 036077426) |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2023-12-22 |