| NPI | 1629234851 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA MD443170) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 036151210) |
| Enumeration Date | 2008-08-07 |
| Last Update Date | 2026-02-09 |