| NPI | 1427553734 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 34.017523) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 036156315) |
| Enumeration Date | 2018-03-28 |
| Last Update Date | 2025-08-04 |