| NPI | 1518349984 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 036162078) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MS 25257) |
| Enumeration Date | 2015-06-22 |
| Last Update Date | 2024-02-29 |