| NPI | 1538173414 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 036108144) |
| Additional Taxonomies | 207QA0505X Family Medicine Adult Medicine (Licence: IL 036108144) |
| 207P00000X Emergency Medicine (Licence: IN 01065961A) | |
| Enumeration Date | 2006-07-28 |
| Last Update Date | 2009-10-05 |