| NPI | 1780830703 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 036141752) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IL 036141752) |
| 207Q00000X Family Medicine (Licence: PA MD453720) | |
| 207Q00000X Family Medicine (Licence: IN 01068800A) | |
| Enumeration Date | 2008-08-11 |
| Last Update Date | 2024-03-20 |