| NPI | 1548309982 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 36069180) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IN 01082742A) |
| Enumeration Date | 2007-02-05 |
| Last Update Date | 2019-08-15 |