| NPI | 1942208087 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 036068792) |
| Additional Taxonomies | 207QB0002X Family Medicine, Bariatric Medicine (Licence: IL 036068792) |
| 207QS0010X Family Medicine, Sports Medicine (Licence: IL 036068792) | |
| Enumeration Date | 2005-07-12 |
| Last Update Date | 2024-05-15 |