| NPI | 1679663603 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IN 02005477A) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 036105186) |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2023-04-18 |