| NPI | 1639799109 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: IL 036.164104) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA A176759) |
| 207QH0002X Family Medicine, Hospice and Palliative Medicine (Licence: IL 036.164104) | |
| 208D00000X General Practice (Licence: CA A176759) | |
| Enumeration Date | 2020-04-24 |
| Last Update Date | 2023-07-03 |