| NPI | 1316063399 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 036-058768) |
| Additional Taxonomies | 208600000X Surgery (Licence: IL 036-058768) |
| 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine (Licence: IL 036058768) | |
| 208D00000X General Practice (Licence: IL 036058768) | |
| 2083P0500X Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine (Licence: IL 036058768) | |
| 207Q00000X Family Medicine (Licence: IL 036058768) | |
| Enumeration Date | 2007-03-22 |
| Last Update Date | 2023-03-07 |