| NPI | 1578556544 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 036-096088) |
| Additional Taxonomies | 173000000X Legal Medicine (Licence: IL 036096088) |
| Enumeration Date | 2005-08-25 |
| Last Update Date | 2009-12-15 |