NPI | 1750368452 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 036-069509) |
Additional Taxonomies | 207QS0010X Family Medicine, Sports Medicine (Licence: IL 036-069509) |
Enumeration Date | 2005-12-23 |
Last Update Date | 2016-05-19 |