| NPI | 1164513719 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IN 01073267A) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 036-107837) |
| Enumeration Date | 2006-09-27 |
| Last Update Date | 2014-04-18 |