| NPI | 1437274990 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AZ 42143) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 036.176966) |
| Enumeration Date | 2007-03-20 |
| Last Update Date | 2025-10-06 |