| NPI | 1992931661 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 036129522) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 125055960) |
| Enumeration Date | 2009-06-08 |
| Last Update Date | 2021-12-27 |