| NPI | 1457433039 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 036-100650) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 036100650) |
| Enumeration Date | 2006-10-20 |
| Last Update Date | 2018-03-23 |