NPI | 1215553706 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 036162046) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 125077121) |
Enumeration Date | 2020-06-19 |
Last Update Date | 2023-06-29 |