| NPI | 1265963383 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 036.152694) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 125070433) |
| Enumeration Date | 2017-03-21 |
| Last Update Date | 2022-12-10 |