| NPI | 1689960650 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 036134206) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IN 11016194A) |
| Enumeration Date | 2011-06-28 |
| Last Update Date | 2024-02-20 |