| NPI | 1326779349 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 036174672) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA OT021865) |
| Enumeration Date | 2022-06-21 |
| Last Update Date | 2025-06-13 |