| NPI | 1871507236 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: IL 036073831) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IL 036073831) |
| Enumeration Date | 2006-07-28 |
| Last Update Date | 2025-10-01 |