| NPI | 1922259787 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 036121756) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA A121880) |
| Enumeration Date | 2008-10-09 |
| Last Update Date | 2022-04-01 |