| NPI | 1568908283 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085-006181) |
| Enumeration Date | 2017-01-19 |
| Last Update Date | 2025-02-06 |