| NPI | 1467832683 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MD D85981) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 125-067044) |
| Enumeration Date | 2015-06-03 |
| Last Update Date | 2018-08-29 |