| NPI | 1760844583 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 036.148792) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 125068093) |
| Enumeration Date | 2016-03-22 |
| Last Update Date | 2019-06-20 |