| NPI | 1336600543 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MI 5101026814) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 036171828) |
| 207Q00000X Family Medicine (Licence: IL 125073791) | |
| Enumeration Date | 2019-03-29 |
| Last Update Date | 2024-11-22 |