| NPI | 1417432261 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: IL 036181364) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 125.081276) |
| Enumeration Date | 2018-09-27 |
| Last Update Date | 2026-08-06 |