| NPI | 1831105808 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IN 01066790A) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 036-121930) |
| Enumeration Date | 2006-07-31 |
| Last Update Date | 2021-03-18 |