| 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 | 2025-07-01 |