| NPI | 1558463505 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 036-126471) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA OS006379L) |
| Enumeration Date | 2006-09-01 |
| Last Update Date | 2016-05-19 |