| NPI | 1376653352 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MI 5101013067) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IL 036118642) |
| 207Q00000X Family Medicine (Licence: IL 036118642) | |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2022-07-12 |