| NPI | 1962999771 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 036166068) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA A173885) |
| Enumeration Date | 2018-04-17 |
| Last Update Date | 2024-01-02 |