| NPI | 1447580022 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 036124770) |
| Additional Taxonomies | 208600000X Surgery (Licence: IL 036124770) |
| 208D00000X General Practice (Licence: IL 036124770) | |
| Enumeration Date | 2010-01-05 |
| Last Update Date | 2011-06-29 |