| NPI | 1083061568 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IN 02005706A) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 125.068437) |
| Enumeration Date | 2016-05-16 |
| Last Update Date | 2024-08-02 |