| NPI | 1427426931 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 036.144603) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 125067915) |
| Enumeration Date | 2015-09-14 |
| Last Update Date | 2018-12-05 |