| NPI | 1336670801 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 036-157224) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MS 27901) |
| Enumeration Date | 2017-03-25 |
| Last Update Date | 2023-08-17 |