NPI | 1942280797 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208D00000X General Practice (Licence: IL 036114471) |
Additional Taxonomies | 202K00000X (Licence: MO 2005037958) |
Enumeration Date | 2006-01-18 |
Last Update Date | 2011-02-18 |