| NPI | 1700317633 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 036161637) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IN 02005934A) |
| Enumeration Date | 2017-03-22 |
| Last Update Date | 2023-05-30 |