| NPI | 1649217985 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 036046824) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 036046824) |
| Enumeration Date | 2006-06-02 |
| Last Update Date | 2023-03-07 |