| NPI | 1275616955 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IN 01082063A) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 036-106018) |
| Enumeration Date | 2006-10-24 |
| Last Update Date | 2024-04-19 |