| NPI | 1457739229 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 036147250) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 336108258) |
| 207Q00000X Family Medicine (Licence: CA A169436) | |
| Enumeration Date | 2015-05-13 |
| Last Update Date | 2022-05-10 |