| NPI | 1225485485 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OR MD197934) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 125071368) |
| Enumeration Date | 2016-05-18 |
| Last Update Date | 2022-01-05 |