| NPI | 1558655167 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 036137561) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AR E-8928) |
| Enumeration Date | 2011-06-01 |
| Last Update Date | 2019-09-12 |