| NPI | 1619236262 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: IL 036.129440) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 036.129440) |
| Enumeration Date | 2012-05-16 |
| Last Update Date | 2025-08-22 |