NPI | 1750939674 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085.007269) |
Enumeration Date | 2019-09-04 |
Last Update Date | 2023-10-20 |