| NPI | 1922152370 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 03648335) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IL 03648335) |
| Enumeration Date | 2007-01-23 |
| Last Update Date | 2010-09-23 |