| NPI | 1396772976 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 036.075884) |
| Additional Taxonomies | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: IL 036-075884) |
| 207Q00000X Family Medicine (Licence: AZ 48214) | |
| Enumeration Date | 2006-06-27 |
| Last Update Date | 2023-06-27 |