| NPI | 1669720017 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 036137206) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 125.062482) |
| Enumeration Date | 2012-08-16 |
| Last Update Date | 2015-04-28 |