| NPI | 1710979760 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IN 01055431A) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 036106682) |
| Enumeration Date | 2005-08-16 |
| Last Update Date | 2023-08-10 |