| NPI | 1588928907 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 036136832) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 125-062337) |
| Enumeration Date | 2012-06-29 |
| Last Update Date | 2019-12-27 |