| NPI | 1881694222 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 036057226) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IL 036057226) |
| Enumeration Date | 2005-07-28 |
| Last Update Date | 2018-12-19 |