| NPI | 1699720144 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IN 02000603A) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 036057151) |
| Enumeration Date | 2006-05-23 |
| Last Update Date | 2010-03-03 |