| NPI | 1689860355 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: GA 063248) |
| Additional Taxonomies | 208D00000X General Practice (Licence: IL 36117613) |
| Enumeration Date | 2007-09-17 |
| Last Update Date | 2009-10-21 |