| NPI | 1932692746 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA MT215738) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 036157634) |
| Enumeration Date | 2018-06-07 |
| Last Update Date | 2023-07-11 |