NPI | 1598292799 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: AZ 67313) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 036151131) |
207Q00000X Family Medicine (Licence: IL 0361117063) | |
Enumeration Date | 2017-05-18 |
Last Update Date | 2024-09-26 |