| NPI | 1326507567 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 125075200) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 125.075200) |
| Enumeration Date | 2019-03-18 |
| Last Update Date | 2021-08-10 |