| NPI | 1598020836 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 036138248) |
| Additional Taxonomies | 208600000X Surgery (Licence: IL 036138248) |
| Enumeration Date | 2012-07-12 |
| Last Update Date | 2021-07-07 |