| NPI | 1851617856 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MI 4301102565) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 036131894) |
| Enumeration Date | 2010-04-15 |
| Last Update Date | 2024-02-12 |