| NPI | 1548290901 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 036123588) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IN 11013121A) |
| Enumeration Date | 2006-07-03 |
| Last Update Date | 2020-10-14 |