| NPI | 1285126656 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207QG0300X Family Medicine, Geriatric Medicine (Licence: IL 036.156145) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 5101023943) |
| Enumeration Date | 2018-06-01 |
| Last Update Date | 2022-06-20 |