| NPI | 1649652389 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 036146031) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 125066556) |
| Enumeration Date | 2015-06-18 |
| Last Update Date | 2018-08-23 |