| NPI | 1679140891 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 036171961) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 125078542) |
| Enumeration Date | 2021-06-07 |
| Last Update Date | 2026-03-11 |