| NPI | 1265126478 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 036179399) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IN 11022981A) |
| Enumeration Date | 2023-06-08 |
| Last Update Date | 2026-07-31 |