| NPI | 1568566156 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TN 61355) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 036073847) |
| Enumeration Date | 2006-09-12 |
| Last Update Date | 2020-08-26 |