| NPI | 1831184613 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 036-111697) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IL 036-111697) |
| Enumeration Date | 2005-09-16 |
| Last Update Date | 2014-11-29 |