| NPI | 1568485043 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208D00000X General Practice (Licence: IL 036061031) |
| Additional Taxonomies | 207QA0505X Family Medicine Adult Medicine (Licence: IL 036-061031) |
| 207R00000X Internal Medicine (Licence: IL 036061031) | |
| 209800000X Legal Medicine (Licence: IL 036-061031) | |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2017-10-25 |