| NPI | 1447781521 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 036.151804) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IN 02006300A) |
| Enumeration Date | 2017-03-21 |
| Last Update Date | 2022-09-07 |