| NPI | 1588978118 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: DE C1-0011080) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 125060123) |
| Enumeration Date | 2010-08-06 |
| Last Update Date | 2016-02-05 |