| NPI | 1386616399 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IN 02005830A) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 036114338) |
| 207Q00000X Family Medicine (Licence: IL 336075335) | |
| 207Q00000X Family Medicine (Licence: IL 036.114338) | |
| Enumeration Date | 2006-02-03 |
| Last Update Date | 2023-01-13 |