| NPI | 1811062300 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 03649033) |
| Additional Taxonomies | 208600000X Surgery (Licence: IL 03649033) |
| Enumeration Date | 2006-11-21 |
| Last Update Date | 2010-12-21 |