| NPI | 1821195603 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 036-096083) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IL 036-096083) |
| 2083X0100X Preventive Medicine, Occupational Medicine (Licence: IL 036-096083) | |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2022-02-08 |