| NPI | 1699353581 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine (Licence: IL 036167406) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 125.077858) |
| Enumeration Date | 2021-03-31 |
| Last Update Date | 2024-09-20 |