| NPI | 1902032014 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 036-136289) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IN 01076066A) |
| 207Q00000X Family Medicine (Licence: CT 051560) | |
| Enumeration Date | 2009-06-03 |
| Last Update Date | 2024-11-06 |