| NPI | 1548230063 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AZ 74266) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 036112389) |
| Enumeration Date | 2006-01-26 |
| Last Update Date | 2025-01-14 |