| NPI | 1215457916 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MD D0091782) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 125071439) |
| Enumeration Date | 2017-06-23 |
| Last Update Date | 2022-03-10 |