| NPI | 1407849078 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 036113814) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IN 01060028A) |
| Enumeration Date | 2005-08-29 |
| Last Update Date | 2016-12-13 |