| NPI | 1700847191 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 036150782) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 125071567) |
| Enumeration Date | 2006-03-28 |
| Last Update Date | 2020-12-03 |