| NPI | 1508108531 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 036138145) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 125062327) |
| Enumeration Date | 2013-03-16 |
| Last Update Date | 2023-04-25 |