NPI | 1821624768 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085007701) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2020-03-22 |
Last Update Date | 2021-09-07 |