| NPI | 1497160352 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 036.141855) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 125.065942) |
| Enumeration Date | 2014-06-29 |
| Last Update Date | 2022-06-16 |