NPI | 1740711050 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 036.153777) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: IN 11019411A) |
Enumeration Date | 2017-03-27 |
Last Update Date | 2021-02-26 |