| NPI | 1699137828 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 036156092) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WI 71215) |
| 207Q00000X Family Medicine (Licence: WI 71215) | |
| Enumeration Date | 2016-03-26 |
| Last Update Date | 2021-12-01 |