| NPI | 1225144827 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X (Licence: IL 036.101504) |
| Additional Taxonomies | 2085R0001X (Licence: IL 036101504) |
| 2085R0001X (Licence: MO R6N58) | |
| Enumeration Date | 2006-08-23 |
| Last Update Date | 2014-01-22 |