| NPI | 1720301690 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine (Licence: IL 036083229) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MD035598E) |
| Enumeration Date | 2010-03-08 |
| Last Update Date | 2020-12-11 |