| NPI | 1578659447 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 036-061-453) |
| Additional Taxonomies | 208D00000X General Practice (Licence: IL 036061453) |
| 207RG0300X Internal Medicine, Geriatric Medicine (Licence: IL 036061453) | |
| Enumeration Date | 2006-10-05 |
| Last Update Date | 2016-09-12 |