| NPI | 1609037308 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 036-126851) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 125-054982) |
| Enumeration Date | 2008-06-24 |
| Last Update Date | 2011-08-09 |