| NPI | 1417341785 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 036.144124) |
| Additional Taxonomies | 207QA0401X Family Medicine, Addiction Medicine (Licence: IL 036.144124) |
| Enumeration Date | 2015-03-25 |
| Last Update Date | 2025-03-14 |