| NPI | 1396982534 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 036032879) |
| Additional Taxonomies | 208600000X Surgery (Licence: IL 036032879) |
| Enumeration Date | 2009-01-09 |
| Last Update Date | 2011-03-21 |