| NPI | 1134218027 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 36121646) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IN 02002444A) |
| Enumeration Date | 2006-10-11 |
| Last Update Date | 2021-03-02 |