| NPI | 1760480396 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 036130371) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IN 01047441A) |
| Enumeration Date | 2005-07-08 |
| Last Update Date | 2015-10-08 |