| NPI | 1497733091 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL OS18314) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 036122796) |
| Enumeration Date | 2006-01-04 |
| Last Update Date | 2024-06-18 |