| NPI | 1366462665 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208D00000X General Practice (Licence: IL 036076152) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 036076152) |
| 208000000X Pediatrics (Licence: IL 036076152) | |
| Enumeration Date | 2006-07-20 |
| Last Update Date | 2023-03-07 |