| NPI | 1306282066 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IN 01078790A) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125063009) |
| 208000000X Pediatrics (Licence: IL 125063009) | |
| 208000000X Pediatrics (Licence: IN 01078790A) | |
| 208D00000X General Practice (Licence: IN 01078790A) | |
| Enumeration Date | 2013-05-21 |
| Last Update Date | 2021-09-02 |