| NPI | 1720242480 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TN 62998) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 036130699) |
| 207Q00000X Family Medicine (Licence: IN 11014175A) | |
| Enumeration Date | 2008-07-11 |
| Last Update Date | 2021-08-13 |