| NPI | 1760449938 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207QA0401X Family Medicine, Addiction Medicine (Licence: IL 036084729) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 036084729) |
| 207QB0002X Family Medicine, Bariatric Medicine (Licence: IL 036084729) | |
| Enumeration Date | 2006-04-28 |
| Last Update Date | 2019-12-19 |