| NPI | 1841380714 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 036-118352) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 4301083528) |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2023-12-08 |