| NPI | 1235659475 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 036152393) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: ND RL14653) |
| Enumeration Date | 2017-06-20 |
| Last Update Date | 2021-04-14 |