| NPI | 1457311524 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208D00000X General Practice (Licence: IL 036092571) |
| Additional Taxonomies | 202K00000X (Licence: IL 036-092571) |
| Enumeration Date | 2006-03-24 |
| Last Update Date | 2022-10-13 |