NPI | 1477203057 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine (Licence: IL 036173455) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 1477203057) |
Enumeration Date | 2022-03-25 |
Last Update Date | 2025-07-21 |