| NPI | 1598759201 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 036044169) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 0036044169) |
| Enumeration Date | 2005-09-08 |
| Last Update Date | 2021-12-20 |