| NPI | 1750390381 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 036110372) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IN 01056583A) |
| Enumeration Date | 2006-08-05 |
| Last Update Date | 2021-02-10 |