| NPI | 1255477857 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IN 01050338A) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 036-096640) |
| Enumeration Date | 2007-01-30 |
| Last Update Date | 2020-08-14 |