| NPI | 1245257781 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 036-115012) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 036115012) |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2018-05-15 |