| NPI | 1447353230 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 036058621) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IN 01067070A) |
| 208600000X Surgery (Licence: IL 036058621) | |
| 208D00000X General Practice (Licence: IL 036058621) | |
| Enumeration Date | 2006-09-07 |
| Last Update Date | 2021-02-22 |