| NPI | 1346488400 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 202K00000X (Licence: IL 036-126661) |
| Additional Taxonomies | 208D00000X General Practice (Licence: IL 036-126661) |
| Enumeration Date | 2009-01-28 |
| Last Update Date | 2024-09-30 |