| NPI | 1861557399 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 0368127891) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA 20A9687) |
| Enumeration Date | 2006-12-26 |
| Last Update Date | 2013-01-25 |