| NPI | 1538185095 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X (Licence: IL 036-097303) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 036097303) |
| 2085R0001X (Licence: WI 5146-320) | |
| 2085R0001X (Licence: IL 036097303) | |
| 2085R0203X Radiology, Therapeutic Radiology (Licence: MI EMC0006393) | |
| 208D00000X General Practice (Licence: IL 036097303) | |
| Enumeration Date | 2006-07-15 |
| Last Update Date | 2025-04-07 |