| NPI | 1629277306 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 036138260) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IN 01062766A) |
| Enumeration Date | 2007-07-13 |
| Last Update Date | 2015-11-13 |