| NPI | 1801003991 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 036-069407) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 036069407) |
| Enumeration Date | 2007-05-17 |
| Last Update Date | 2008-12-22 |