| NPI | 1043202567 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 036-108619) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IN 01058075A) |
| 207P00000X Emergency Medicine (Licence: IN 01058075A) | |
| Enumeration Date | 2005-08-19 |
| Last Update Date | 2022-09-23 |