| NPI | 1649224734 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IN 02002588A) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 036110052) |
| 207Q00000X Family Medicine (Licence: IL 0036110052) | |
| Enumeration Date | 2006-05-22 |
| Last Update Date | 2021-04-08 |