| NPI | 1609289636 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 036.143899) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IL 036143899) |
| Enumeration Date | 2014-06-06 |
| Last Update Date | 2021-12-06 |