| NPI | 1033596929 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IN 01080220A) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 036.144725) |
| Enumeration Date | 2015-04-30 |
| Last Update Date | 2023-05-18 |