| NPI | 1922034909 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: IL 036-047763) |
| Additional Taxonomies | 208D00000X General Practice (Licence: IL 036047763) |
| Enumeration Date | 2006-06-23 |
| Last Update Date | 2015-12-17 |