| NPI | 1215906847 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 036107899) |
| Additional Taxonomies | 207QS0010X Family Medicine, Sports Medicine (Licence: CA A065118) |
| Enumeration Date | 2006-03-16 |
| Last Update Date | 2021-11-29 |