NPI | 1750310363 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 036057121) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: IN 02002781a) |
Enumeration Date | 2006-07-03 |
Last Update Date | 2021-08-05 |