NPI | 1427537521 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 036157279) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA OT018892) |
Enumeration Date | 2018-08-09 |
Last Update Date | 2021-09-03 |