| NPI | 1457562944 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: WI 46635020) |
| Additional Taxonomies | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: WI 46635-020) |
| 202K00000X (Licence: WI 46635-020) | |
| 207Q00000X Family Medicine (Licence: IL 036121623) | |
| Enumeration Date | 2007-05-25 |
| Last Update Date | 2016-07-13 |