| NPI | 1225135940 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 036051910) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IL 036051910) |
| 207R00000X Internal Medicine (Licence: IL 036051910) | |
| Enumeration Date | 2006-09-17 |
| Last Update Date | 2023-03-07 |