| NPI | 1407424286 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 036-171780) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 125.078979) |
| Enumeration Date | 2021-06-16 |
| Last Update Date | 2025-03-25 |