| NPI | 1407856503 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NV 15941) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 036077443) |
| Enumeration Date | 2005-07-29 |
| Last Update Date | 2024-11-18 |