NPI | 1265690523 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 036123623) |
Additional Taxonomies | 207QS0010X Family Medicine, Sports Medicine (Licence: IL 036123623) |
Enumeration Date | 2008-05-23 |
Last Update Date | 2022-10-05 |