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 |