| NPI | 1790798593 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: ID MC-2626) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 036091551) |
| Enumeration Date | 2006-08-14 |
| Last Update Date | 2025-07-25 |