| NPI | 1881893303 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 036-124359) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 125053459) |
| Enumeration Date | 2007-07-13 |
| Last Update Date | 2024-02-27 |