| NPI | 1912136896 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MD D84017) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 036131213) |
| Enumeration Date | 2009-07-13 |
| Last Update Date | 2019-03-15 |