| NPI | 1679704100 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MI 4301100135) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IL 036142021) |
| Enumeration Date | 2009-07-31 |
| Last Update Date | 2021-05-05 |