| NPI | 1538114715 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 036103121) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IL 03613121) |
| 208D00000X General Practice (Licence: IL 036103121) | |
| Enumeration Date | 2006-05-24 |
| Last Update Date | 2024-07-18 |