NPI | 1649446824 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 036133682) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: MN 51603) |
Enumeration Date | 2008-05-07 |
Last Update Date | 2025-06-04 |