| NPI | 1679140966 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IN 01093006A) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 125.078700) |
| Enumeration Date | 2021-06-07 |
| Last Update Date | 2024-08-09 |