| NPI | 1467893461 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 036144076) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IA R9738) |
| Enumeration Date | 2013-07-08 |
| Last Update Date | 2021-03-26 |