| NPI | 1881186773 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 036.172794) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AZ 009149) |
| Enumeration Date | 2018-06-05 |
| Last Update Date | 2025-03-09 |